Provider Demographics
NPI:1093061269
Name:SOUTHERN HEALTH PARTNERS, INC.
Entity Type:Organization
Organization Name:SOUTHERN HEALTH PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRSINE
Authorized Official - Suffix:
Authorized Official - Credentials:CCHP
Authorized Official - Phone:423-553-5635
Mailing Address - Street 1:2030 HAMILTON PLACE BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6038
Mailing Address - Country:US
Mailing Address - Phone:423-553-5635
Mailing Address - Fax:423-553-5645
Practice Address - Street 1:2030 HAMILTON PLACE BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6038
Practice Address - Country:US
Practice Address - Phone:423-553-5635
Practice Address - Fax:423-553-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service