South Side Community Health
LBN: Chattanooga Hamilton County Hospital Authority
South Side Community Health is an health care organization with primary practice located at 3800 Tennessee Ave Ste 124 , Chattanooga TN 37409-1260. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty.
Chattanooga Hamilton County Hospital Authority can be contacted via phone (423) 778-4780, or through Shaver, Mike Dale via phone (423) 240-8576.
Contact Information
Primary practice address
3800 Tennessee Ave Ste 124
Chattanooga TN 37409-1260
Phone: (423) 778-4780
Fax: (423) 778-4833
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | 0000000140 | Tennessee |
Profile Details
| NPI number | 1962597179 |
|---|---|
| LBN Legal business name | Chattanooga Hamilton County Hospital Authority |
| DBA Doing business as | South Side Community Health |
| Authorized official | Shaver, Mike Dale |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Mar 10th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962597179 | NPPES |
| Georgia | MEDICAID | 000451481A |
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