Provider Demographics
NPI:1255386348
Name:SURGERY CENTER OF CHATTANOOGA LP
Entity type:Organization
Organization Name:SURGERY CENTER OF CHATTANOOGA LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-762-6111
Mailing Address - Street 1:7450 TYNER RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1078
Mailing Address - Country:US
Mailing Address - Phone:423-698-6874
Mailing Address - Fax:423-622-8993
Practice Address - Street 1:7450 TYNER RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1078
Practice Address - Country:US
Practice Address - Phone:423-698-6874
Practice Address - Fax:423-622-8993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3739752Medicare PIN