| Organization Name: | HICKMAN COMMUNITY HEALTH CARESERVICES |
| NPI Number: | 1225049570 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNA L MATHIS (BUSINESS OFFICE MANAGER) |
| Mailing Address: | 5047 Highway 100 Lyles |
| State: | TN US |
| Postal Code: | 370981878 |
| Phone Number: | 9316706525 |
| Fax Number: | 9316706527 |
| NPI Enumeration Date: | 08/11/2006 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |