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General NPI Number Information
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NPI Number | 1841158375
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Entity Type | Organization
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Legal Business Name | DARSALUD COMMUNITY CENTER INC
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 6625 LENOX PARK DR STE 101
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City | MEMPHIS
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State | TN
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Zip | 38115-4397
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Country | US
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Telephone | 901-683-0024
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Fax | 901-683-0086
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Provider Business Mailing Address
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Address Line | 6625 LENOX PARK DR STE 202
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City | MEMPHIS
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State | TN
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Zip | 38115-8200
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Country | US
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Telephone | 901-683-0024
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Fax | 901-683-0086
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Authorized Official
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Title or Position | BILLING AND CREDENTIALING MANAGER
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Name | ANDREA IVORY FULLER
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Credential | CPC
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Telephone | 901-922-5951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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