Healthcare Provider Details

I. General information

NPI: 1124459557
Provider Name (Legal Business Name): WELL CHILD SCHOOL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 NEW YORK ST
MEMPHIS TN
38104-5536
US

IV. Provider business mailing address

650 NEW YORK ST
MEMPHIS TN
38104-5536
US

V. Phone/Fax

Practice location:
  • Phone: 901-728-5858
  • Fax:
Mailing address:
  • Phone: 901-728-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number15523
License Number StateTN

VIII. Authorized Official

Name: DR. APRIL SANCHEZ
Title or Position: MD
Credential:
Phone: 901-728-5858