Provider Demographics
NPI:1073714101
Name:HOSPICE OF CHATTANOOGA, INC.
Entity Type:Organization
Organization Name:HOSPICE OF CHATTANOOGA, INC.
Other - Org Name:PALLIATIVE CARE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-235-4123
Mailing Address - Street 1:500 FAULCONER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5089
Mailing Address - Country:US
Mailing Address - Phone:434-235-4123
Mailing Address - Fax:434-235-4143
Practice Address - Street 1:2030 HAMILTON PLACE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6040
Practice Address - Country:US
Practice Address - Phone:423-553-1823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3709933Medicare ID - Type UnspecifiedPART B GROUP NUMBER