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General NPI Number Information
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NPI Number | 1134559073
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Entity Type | Organization
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Legal Business Name | THE SAPPHIRE GROUP INC
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Dates
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Enumeration Date | 11/13/2013
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 4466 ELVIS PRESLEY BLVD SUITE 115
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City | MEMPHIS
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State | TN
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Zip | 38116-7180
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Country | US
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Telephone | 901-300-6451
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Fax | 855-647-3546
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Provider Business Mailing Address
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Address Line | 4466 ELVIS PRESLEY BLVD SUITE 115
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City | MEMPHIS
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State | TN
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Zip | 38116-7180
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Country | US
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Telephone | 901-300-6451
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Fax | 855-647-3546
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | MR. HENDERSON WILBORN II
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Credential |
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Telephone | 901-300-6451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 44D2067576
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License Number State | TN
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