=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255224036
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL & ALL DIAGNOSTICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2025
-----------------------------------------------------
Last Update Date | 05/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3173 KIRBY WHITTEN RD STE 106
-----------------------------------------------------
City | BARTLETT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38134-2881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-618-9708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8818 LYBROOK CV E
-----------------------------------------------------
City | CORDOVA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38016-4011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NNEKA DANIELS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 901-618-9708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------