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General NPI Number Information
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NPI Number | 1699433037
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Entity Type | Organization
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Legal Business Name | MEMPHIS URGENT CARE #2, LLC.
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 5142 GOODMAN RD STE 107
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8971
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Country | US
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Telephone | 662-874-5755
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Fax | 662-874-5768
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Provider Business Mailing Address
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Address Line | 5142 GOODMAN RD STE 107
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8971
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Country | US
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Telephone | 662-874-5755
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Fax | 662-874-5768
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Authorized Official
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Title or Position | VP, CFO TPR
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Name | BRIAN RASMUS
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Credential |
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Telephone | 469-893-2532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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