Provider Demographics
NPI:1285735480
Name:MORRISTOWN HAMBLEN HOSPITAL
Entity type:Organization
Organization Name:MORRISTOWN HAMBLEN HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:423-587-2443
Mailing Address - Street 1:1621 W MORRIS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2832
Mailing Address - Country:US
Mailing Address - Phone:423-587-2443
Mailing Address - Fax:423-586-9988
Practice Address - Street 1:1621 W MORRIS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2832
Practice Address - Country:US
Practice Address - Phone:423-587-2443
Practice Address - Fax:423-586-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2006007170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN0000150381OtherREGISTERED NURSE STATE TN
TN2006007170OtherANCC