Organization
KIDNEY CENTER OF OOLTEWAH- COLLEGEDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN CHAMBERLAIN M.D. (ADMINISTRATOR)
(423) 443-2146
Entity
Organization
Contact information
Practice address
5483 LITTLE DEBBIE PKWY, OOLTEWAH, TN 37363-8409
(423) 541-3450
(423) 541-3451
Mailing address
3810 BRAINERD RD, CHATTANOOGA, TN 37411-3729
(423) 486-9514
(423) 702-7912
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q050145
—
TN
Enumeration date
05/11/2017
Last updated
12/02/2021
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