COFFEE COUNTY HOSPITAL GROUP, INC (NPI# 1215941646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215941646 |
| Entity Type | Organization |
| Organization Name | COFFEE COUNTY HOSPITAL GROUP, INC |
| Other Organization Name | MEDICAL CENTER OF MANCHESTER |
| Practice Address |
481 Interstate Dr Manchester TN 37355-3108 |
| Mailing Address |
Po Box 1409 Manchester TN 37349-4409 |
| Practice Telephone | 9317286354 |
| Practice Fax Number | 9317285420 |
| Mailing Telephone | 9317286354 |
| Mailing Fax Number | 9317285420 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2016-06-02 |
| Authorized Official Name | MR. ROBERT J. COUCH (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9317286354 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
000000000019 | TN | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 0441308 | 05 | |
| TN | TENNCARE PROVIDER NUMBER | 1000063 | 01 |
| Other Name | Type Code |
|---|---|
| MEDICAL CENTER OF MANCHESTER | Former Legal Business Name - Organization |
| Street Address |
481 INTERSTATE DR |
| City | MANCHESTER |
| State | TN |
| Zip Code | 37355-3108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013969179 | Coffee Medical Group LLC | General Acute Care Hospital | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-05-17 |
| 1447704846 | Bledsoe Falls Emergency Physicians LLC | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2016-08-15 |
| 1972724722 | Coffee County Hospital Group Inc | Medicare Defined Swing Bed Unit | 481 Interstate Dr, Manchester, TN 37355-3108 | 2007-05-01 |
| 1235145459 | James M Reed | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-31 |
| 1437164878 | Coffee County Physician Group PC | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-31 |
| 1356356281 | Isaac H Stovall | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-29 |
| 1467495119 | Marsha L Marlin | Nurse Anesthetist, Certified Registered | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857126 | Ashley Harmon Layne | Speech-Language Pathologist | 205 S Woodland St, Manchester, TN 37355 | 2018-07-17 |
| 1760996771 | Quad/med, LLC | Clinic/Center | 227 Monogard Rd, Manchester, TN 37355 | 2017-11-29 |
| 1881108157 | Sarabeth Seagreaves | Specialist/Technologist | 1700 Summer St Apt A36, Manchester, TN 37355 | 2017-11-25 |
| 1639618663 | Heather N Fesmire | Surgery | 1030 Mcarthur St., Manchester, TN 37355 | 2017-02-23 |
| 1316361561 | Charlotte Gibbs | Counselor | 482 Interstate Dr Ste D, Manchester, TN 37355 | 2014-02-08 |
| 1205258191 | Aleene Marie Falk | Social Worker | 218 Forrestwood Drive, Manchester, TN 37355 | 2014-01-10 |
| 1790067429 | Reda Lynn Lawson | Registered Nurse | 800 Parks Street, Manchester, TN 37355 | 2011-09-20 |
| 1912294117 | Patricia Beth Elliott | Nurse Practitioner | 804 Keylon Street, Manchester, TN 37355 | 2011-07-08 |
| 1427241421 | Kimberly D. Mathis | Nurse Practitioner | 1600 Mcarthur Street, Manchester, TN 37355 | 2007-08-22 |
| 1982761441 | Richard Eugene Fishbein | Orthopaedic Surgery | 102 East High Street, Manchester, TN 37355 | 2007-01-03 |
| Find all providers in zip 37355 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1750354676 | Delaware County Memorial Hospital | General Acute Care Hospital | 709 W Main St, Manchester, IA 52057-1526 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861763963 | Sonja Renee Gregory | General Acute Care Hospital | 1208b Scottsville Rd, Lafayette, TN 37083-2231 | 2012-01-20 |
| 1720036841 | Trinity Hospital LLC | General Acute Care Hospital | 5001 E Main St, Erin, TN 37061-4115 | 2006-05-04 |
| 1659347920 | Camden General Hospital, Inc. | General Acute Care Hospital | 175 Hospital Dr, Camden, TN 38320-1617 | 2006-02-27 |
| 1750363115 | Copper Basin Community Hospital Inc | General Acute Care Hospital | 144 Medical Center Drive, Copperhill, TN 37317 | 2005-11-18 |
| 1417938846 | Macon County General Hospital, Inc. | General Acute Care Hospital | 204 Medical Drive, Lafayette, TN 37083-9999 | 2005-11-11 |
| 1811987084 | Rhea Medical Center | General Acute Care Hospital | 9400 Rhea County Hwy, Dayton, TN 37321-7922 | 2005-10-27 |
| 1376175687 | Lauderdale Community Hospital LLC | General Acute Care Hospital | 326 Asbury Ave, Ripley, TN 38063-5577 | 2020-02-05 |
| 1104472372 | Rural Hospitals and Clinics of America, Inc | General Acute Care Hospital | 100 Old Jefferson St, Celina, TN 38551-4040 | 2019-08-14 |
| 1962981878 | Houston County Community Hospital | General Acute Care Hospital | 5001 E Main St, Erin, TN 37061-4115 | 2018-08-10 |
| 1851759526 | Community Pharmacy | General Acute Care Hospital | 1818 Albion St, Nashville, TN 37208-2918 | 2016-02-09 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 37355 |
Please comment or provide details below to improve the information on COFFEE COUNTY HOSPITAL GROUP, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.