THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER LLC NPI 1740256197

NPI Information

NPI: 1740256197
Provider Name: THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2515 DESALES AVE
CHATTANOOGA, TN
ZIP 37404
Phone: (423) 648-6672
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THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC is an ambulatory surgical clinic center in Chattanooga, TN. THE ASSOCIATES OF MEMORIAL MISSION SURGERY CENTER, LLC NPI is 1740256197. The provider is registered as an organization entity type.

The provider's business location address is:

2515 DESALES AVE
CHATTANOOGA, TN
ZIP 37404-100
Phone: (423) 648-6672
Fax: (423) 648-5312

The provider's authorized official is Alan Shikoh .
The authorized official title is Chairman Of The Board and has the following contact phone number (423) 648-6672.

The enumeration date for this NPI number is 2/27/2006 and was last updated on 3/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	147	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3288753	MEDICAID	TENNESSEE
2	4053703	OTHER	TENNESSEE	BCBS OF TN
3	261507535A	MEDICAID	GEORGIA
4	3288753	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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