Provider Demographics
NPI:1770678617
Name:CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
Other - Org Name:ERLANGER BLEDSOE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND 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 1:71 WHEELERTOWN AVENUE
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367-0699
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:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000005282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0441306Medicaid
TN441306Medicare Oscar/Certification