Healthcare Provider Details

I. General information

NPI: 1750828844
Provider Name (Legal Business Name): BMHSI/AEL MICROBIOLOGY LABORATORY, GP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 CENTURY CENTER CV SUITE 200
MEMPHIS TN
38134-8975
US

IV. Provider business mailing address

1701 CENTURY CENTER CV SUITE 200
MEMPHIS TN
38134-8975
US

V. Phone/Fax

Practice location:
  • Phone: 901-405-8200
  • Fax: 901-844-8669
Mailing address:
  • Phone: 901-405-8200
  • Fax: 901-844-8669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW DRESS
Title or Position: CEO
Credential: MD
Phone: 901-405-8200