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General NPI Number Information
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NPI Number | 1124620950
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Entity Type | Organization
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Legal Business Name | POPLAR MEDICAL, LLC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 5050 POPLAR AVE STE 1901
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City | MEMPHIS
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State | TN
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Zip | 38157-0101
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Country | US
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Telephone | 901-708-8600
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Fax | 901-730-1230
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Provider Business Mailing Address
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Address Line | 5050 POPLAR AVE STE 1901
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City | MEMPHIS
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State | TN
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Zip | 38157-0101
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Country | US
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Telephone | 901-708-8600
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Fax | 901-730-1230
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MARY SMITH
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Credential |
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Telephone | 901-708-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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