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NPI Code Detail

MEDICARE: MEDIPHARM INC.

MEDICARE: MEDIPHARM INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPN 16134TN
2246RP1900XPhlebotomy Technician44D2021574TN
3207R00000XInternal Medicine PhysicianMD7664TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11780980631OTHERTNSPECIALTY PHARMACY
21942476528OTHERTNRETAIL PHARMACY

General Provider Information

NPI Number : 1033406111
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDIPHARM INC.
Provider Business Mailing Address
First Line : 295 S BELLEVUE BLVD
Second Line : SUITE # 3
City : MEMPHIS
State : TN
Zip : 38104-7517
Country : US
Telephone Number : 901-746-9631
Fax Number : 901-791-9292
Provider Business Practice Location Address
First Line : 295 S BELLEVUE BLVD
Second Line : SUITE # 3
City : MEMPHIS
State : TN
Zip : 38104-7517
Country : US
Telephone Number : 901-746-9631
Fax Number : 901-791-9292
Authorized Official
Title or Position : ADMINISTRATOR/CEO
Name : NYANDAY R. OTI
Credential :
Telephone Number : 901-746-9631
Provider Enumeration Date : 07/08/2011
Last Update Date : 11/28/2011

Similar Medicare Providers

1780980631 — MEDIPHARM INC
Practice Location Address:
295 S BELLEVUE BLVD STE 1A
MEMPHIS, TN
38104-7517
Practice Phone: 901-373-9955
Practice Fax: 901-382-9966
1235427139 — LINDEN BELLEVUE INJURY CLINIC, LLC
Practice Location Address:
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MEMPHIS, TN
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Practice Fax: 901-725-0523
1679509707 — MS. BARBARA ELLA GEATER MD
Practice Location Address:
2245 S LAUDERDALE ST
MEMPHIS, TN
38106-7517
Practice Phone: 901-948-5558
Practice Fax: 901-774-9031
1932262417 — TAMARA HOWARD-FAIN APRN, BC
Practice Location Address:
2245 S LAUDERDALE ST
MEMPHIS, TN
38106-7517
Practice Phone: 901-948-5558
Practice Fax: 901-774-9031
1710038161 — DR. JACK ANDREW GOODMAN M.D.
Practice Location Address:
4515 POPLAR AVE STE 426
MEMPHIS, TN
38117-7517
Practice Phone: 901-683-6083
Practice Fax: 901-761-2364
1225177942 — RENTROP & GEATER PLLC
Practice Location Address:
2245 S LAUDERDALE ST
MEMPHIS, TN
38106-7517
Practice Phone: 901-948-5558
Practice Fax: 901-774-9031

Directions to “MEDIPHARM INC. ” Practice Location

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