Provider Demographics
NPI:1336672708
Name:CHATTANOOGA REGIONAL HEALTH DEPT.
Entity Type:Organization
Organization Name:CHATTANOOGA REGIONAL HEALTH DEPT.
Other - Org Name:SERO
Other - Org Type:Other Name
Authorized Official - Title/Position:BCS RN COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:423-634-1942
Mailing Address - Street 1:1301 RIVERFRONT PKWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2233
Mailing Address - Country:US
Mailing Address - Phone:423-634-1942
Mailing Address - Fax:423-634-1003
Practice Address - Street 1:1301 RIVERFRONT PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2233
Practice Address - Country:US
Practice Address - Phone:423-634-1942
Practice Address - Fax:423-634-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1471725251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care