Healthcare Provider Details

I. General information

NPI: 1518096601
Provider Name (Legal Business Name): SYMED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 LENOX PARK BLVD SUITE 214
MEMPHIS TN
38115-4299
US

IV. Provider business mailing address

55 HATCHETTS HILL RD
OLD LYME CT
06371-1534
US

V. Phone/Fax

Practice location:
  • Phone: 901-273-2368
  • Fax: 901-273-2351
Mailing address:
  • Phone: 800-370-3651
  • Fax: 877-515-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MELISSA KING
Title or Position: DIRECTOR, CREDENTIALING ENROLLMENT
Credential:
Phone: 800-370-3651