MEDICARE: CHATTANOOGA ENDOSCOPY ASC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	0000000098	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	490004372	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447223938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHATTANOOGA ENDOSCOPY ASC LLC

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD
Second Line	:	ATTN: L&C
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6187
Country	:	US
Telephone Number	:	615-240-3741
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 RIVERSIDE DRIVE
Second Line	:	SUITE 117
City	:	CHATTANOOGA
State	:	TN
Zip	:	37406-4332
Country	:	US
Telephone Number	:	423-698-3999
Fax Number	:	423-698-0903

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY SNODGRASS
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	06/28/2022

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Directions to “CHATTANOOGA ENDOSCOPY ASC LLC ” Practice Location

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