Provider Demographics
NPI:1083755987
Name:PARKRIDGE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:PARKRIDGE MEDICAL CENTER, INC.
Other - Org Name:PARKRIDGE VALLEY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:HALVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-499-2384
Mailing Address - Street 1:2200 MORRIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2818
Mailing Address - Country:US
Mailing Address - Phone:423-499-2384
Mailing Address - Fax:
Practice Address - Street 1:2200 MORRIS HILL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2818
Practice Address - Country:US
Practice Address - Phone:423-499-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2010-04-12
Deactivation Date:2009-11-19
Deactivation Code:
Reactivation Date:2010-03-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit