Provider Demographics
NPI:1104874684
Name:PARKRIDGE MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:PARKRIDGE MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:COSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-530-2000
Mailing Address - Street 1:2333 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3258
Mailing Address - Country:US
Mailing Address - Phone:423-698-6061
Mailing Address - Fax:423-493-1208
Practice Address - Street 1:2333 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3258
Practice Address - Country:US
Practice Address - Phone:423-698-6061
Practice Address - Fax:423-493-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1000075OtherBLUE CROSS
NC4400156Medicaid
TN0140003376OtherCIGNA
WV9803981000Medicaid
NJ0054755Medicaid
TN5000069OtherUNITED HEALTH CARE
AR158685105Medicaid
MA7096461Medicaid
GA00312969AMedicaid
TN0411152OtherHEALTHSPRING
LA1707988Medicaid
FL906999200Medicaid
ALHOS0156NMedicaid
TN0440156Medicaid
OH2377842Medicaid
MA7096461Medicaid