Orange Grove Center Primary Health Care Services

LBN: Orange Grove Center, Inc.
Orange Grove Center Primary Health Care Services is an health care organization with primary practice located at 615 Derby St , Chattanooga TN 37404-1632. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Allopathic & Osteopathic Physicians / Adult Medicine, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Allopathic & Osteopathic Physicians / Adult Medicine is the primary health care specialty. Orange Grove Center, Inc. can be contacted via phone (423) 493-2905, or through Roberts, Tera via phone (423) 493-2910.

Contact Information

Primary practice address
615 Derby St Chattanooga TN 37404-1632
Phone: (423) 493-2905
Fax: (423) 493-2950
Website:
Map and Directions
Authorized official contact:
Name: Roberts, Tera
Phone: (423) 493-2910

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8686 Tennessee
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 26723 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 13774 Tennessee

Profile Details

NPI number 1073668653
LBN Legal business name Orange Grove Center, Inc.
DBA Doing business as Orange Grove Center Primary Health Care Services
Authorized official Roberts, Tera
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 24th, 2007
Last updated Mar 4th, 2024 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073668653 NPPES
Tennessee Other CH3763 RR MEDICARE
Tennessee Other 3070512 RR MEDICARE
Tennessee MEDICAID 3399927 RR MEDICARE

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