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General NPI Number Information
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NPI Number | 1902031677
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Entity Type | Organization
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Legal Business Name | STUDENTS, MOTHERS AND CONCERNED CITIZENS
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Dates
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Enumeration Date | 05/23/2009
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Last Update Date | 05/23/2009
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Provider Practice Location Address
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Address Line | 3455 REBEH RD
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City | MEMPHIS
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State | TN
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Zip | 38109-3433
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Country | US
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Telephone | 901-785-9356
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26365
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City | MEMPHIS
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State | TN
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Zip | 38126-0365
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Country | US
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Telephone | 901-785-9356
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARY DELOIS WRIGHT
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Credential | FOUNDER
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Telephone | 901-277-8673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 059824279
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License Number State | TN
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