Healthcare Provider Details

I. General information

NPI: 1255152054
Provider Name (Legal Business Name): PAMELA MARIE ZINK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 LOCHINVAR RD
MEMPHIS TN
38116-7941
US

IV. Provider business mailing address

4901 LOCHINVAR RD
MEMPHIS TN
38116-7941
US

V. Phone/Fax

Practice location:
  • Phone: 832-250-5200
  • Fax:
Mailing address:
  • Phone: 832-250-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number149949491
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: