Provider Demographics
NPI:1306868682
Name:CAMDEN GENERAL HOSPITAL
Entity type:Organization
Organization Name:CAMDEN GENERAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-541-5000
Mailing Address - Street 1:1804 HIGHWAY 45 BYP
Mailing Address - Street 2:SUITE 604
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-4436
Mailing Address - Country:US
Mailing Address - Phone:731-660-8759
Mailing Address - Fax:731-660-8739
Practice Address - Street 1:175 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-1617
Practice Address - Country:US
Practice Address - Phone:731-584-6135
Practice Address - Fax:731-584-0124
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMDEN GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-24
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282NC2000XHospitalsGeneral Acute Care HospitalChildren
No282NR1301XHospitalsGeneral Acute Care HospitalRural
No282NW0100XHospitalsGeneral Acute Care HospitalWomen
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3279467Medicare PIN