Provider Demographics
NPI:1639264575
Name:CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
Other - Org Name:ERLANGER MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:BREXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-778-4780
Mailing Address - Street 1:975 E THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403
Mailing Address - Country:US
Mailing Address - Phone:423-778-4780
Mailing Address - Fax:423-778-4833
Practice Address - Street 1:975 E THIRD STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-778-4780
Practice Address - Fax:423-778-4833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000140282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00002131AMedicaid
CAXHSP41312Medicaid
CAXHSP31312Medicaid
GA00002142AMedicaid
CO95011151Medicaid
KS0134451201Medicaid
AZ028680Medicaid
ALHOSP0104PMedicaid
KY01620855Medicaid
LA1740403Medicaid
IL=========001Medicaid
GA00002142AMedicaid
GA00002131AMedicaid