Organization
CHOTA COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY SELF (CREDENTIALING)
(423) 442-2622
Entity
Organization
Contact information
Practice address
145 FIFTH STREET, TELLICO PLAINS, TN 37385-5046
(423) 253-6545
(423) 253-6538
Mailing address
PO BOX 278, MADISONVILLE, TN 37354-0278
(423) 253-6545
(423) 253-6538
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0441903
—
TN
05
—
1510837
—
TN
05
—
3724536
—
TN
Enumeration date
06/04/2006
Last updated
06/09/2025
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