Provider Demographics
NPI:1699294173
Name:SHELBYVILLE HOSPITAL COMPANY LLC
Entity type:Organization
Organization Name:SHELBYVILLE HOSPITAL COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-778-8076
Mailing Address - Street 1:4000 MERIDIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3335 HIGHWAY 41A N
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37180-5033
Practice Address - Country:US
Practice Address - Phone:931-294-8464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty