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NPI Code Detail

MEDICARE: MID-SOUTH TRANSPLANT FOUNDATION, INC.

MEDICARE: MID-SOUTH TRANSPLANT FOUNDATION, 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
1291U00000XClinical Medical Laboratory0000002214TN

General Provider Information

NPI Number : 1386844504
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID-SOUTH TRANSPLANT FOUNDATION, INC.
Provider Business Mailing Address
First Line : 8001 CENTERVIEW PKWY STE 302
Second Line :
City : CORDOVA
State : TN
Zip : 38018-4228
Country : US
Telephone Number : 901-328-4438
Fax Number : 901-328-4462
Provider Business Practice Location Address
First Line : 8001 CENTERVIEW PKWY STE 302
Second Line :
City : CORDOVA
State : TN
Zip : 38018-4228
Country : US
Telephone Number : 901-328-4438
Fax Number : 901-328-4462
Authorized Official
Title or Position : INTERIM EXECUTIVE DIRECTOR
Name : MRS. KIM VAN FRANK
Credential :
Telephone Number : 901-328-4438
Provider Enumeration Date : 07/25/2007
Last Update Date : 10/06/2008

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Directions to “MID-SOUTH TRANSPLANT FOUNDATION, INC. ” Practice Location

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