Healthcare Provider Details

I. General information

NPI: 1598950685
Provider Name (Legal Business Name): VARANGON INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 BRUNSWICK ROAD
MEMPHIS TN
38134
US

IV. Provider business mailing address

3030 BRUNSWICK RD
BARTLETT TN
38133-4106
US

V. Phone/Fax

Practice location:
  • Phone: 901-531-1950
  • Fax: 901-531-1951
Mailing address:
  • Phone: 901-531-1950
  • Fax: 901-531-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SUSAN I CARRUTHERS
Title or Position: ADMINISTRATOR
Credential: MSW
Phone: 901-531-1950