Organization
COFFEE COUNTY HOSPITAL GROUP INC
Active
Organization
COFFEE COUNTY HOSPITAL GROUP INC
Active
Other names
MEDICAL CENTER OF MANCHESTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J COUCH (CHIEF EXECUTIVE OFFICER)
(931) 728-6354
Entity
Organization
Contact information
Practice address
481 INTERSTATE DR, MANCHESTER, TN 37355-3108
(931) 728-6354
(931) 728-5420
Mailing address
PO BOX 1409, MANCHESTER, TN 37349-4409
(931) 728-6354
(931) 728-5420
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
000000000019
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44Z308
—
TN
Enumeration date
05/01/2007
Last updated
08/22/2020
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