Provider Demographics
NPI:1154559755
Name:SOUTHEAST TENNESSEE HUMAN RESOURCE AGENCY/HAMILTON COUNTY
Entity type:Organization
Organization Name:SOUTHEAST TENNESSEE HUMAN RESOURCE AGENCY/HAMILTON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HAMILTON COUNTY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-949-2191
Mailing Address - Street 1:1617 WILCOX BLVD BLDG B
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37406-4302
Mailing Address - Country:US
Mailing Address - Phone:423-698-7337
Mailing Address - Fax:423-629-3777
Practice Address - Street 1:740 E 12TH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3106
Practice Address - Country:US
Practice Address - Phone:423-949-2191
Practice Address - Fax:423-949-4023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHEAST TENNESSEE HUMAN RESOURCE AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-23
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)