Healthcare Provider Details

I. General information

NPI: 1134561608
Provider Name (Legal Business Name): CHANDLER&IRVING MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1862 POPLAR CREST CV
MEMPHIS TN
38119-4827
US

IV. Provider business mailing address

1862 POPLAR CREST CV
MEMPHIS TN
38119-4827
US

V. Phone/Fax

Practice location:
  • Phone: 901-238-4453
  • Fax: 901-683-4454
Mailing address:
  • Phone: 901-238-4453
  • Fax: 901-683-4454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEVE RAY CHANDLER
Title or Position: CEO
Credential:
Phone: 901-238-4453