Organization
CHATTANOOGA KIDNEY CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDEEP GREWAL M.D. (ADMINISTRATOR)
(423) 648-4900
Entity
Organization
Contact information
Practice address
2118 STEIN DRIVE, CHATTANOOGA, TN 37421-1691
(423) 648-4900
(423) 648-4906
Mailing address
3810 BRAINERD ROAD, CHATTANOOGA, TN 37411-3729
(423) 486-9510
(923) 486-9543
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
0000000138
TN
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003118324A
—
GA
05
—
0442651
—
TN
Enumeration date
01/16/2006
Last updated
08/03/2015
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