Healthcare Provider Details

I. General information

NPI: 1043262280
Provider Name (Legal Business Name): SCENIC CITY MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 FOUNDERS WAY
CHATTANOOGA TN
37416-3680
US

IV. Provider business mailing address

PO BOX 833
HIXSON TN
37343-0833
US

V. Phone/Fax

Practice location:
  • Phone: 423-847-1202
  • Fax: 423-847-1225
Mailing address:
  • Phone: 423-847-1202
  • Fax: 423-847-1225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number000000726
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number000000726
License Number StateTN

VIII. Authorized Official

Name: MR. DELBERT H FRIAR
Title or Position: OWNER
Credential:
Phone: 423-847-1202