NPI 1568564425

Private Senior Providers Etp LLC

Organisation Health Maintenance Organization Memphis, TN

Practice location

Address: 234 Pandora St Co/Brenda Thompson, Memphis, TN 38117-2855
Phone: (901) 315-8619
Fax: (901) 763-2907
Mailing address: PO Box 770193, Memphis, TN 38177-0193

Authorised official

Name: Nancy Sherman Gillespie
Title: Owner
Phone: (901) 315-8619

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

Other Health Maintenance Organization providers in Tennessee →

Registry record

NPI: 1568564425
Entity type: Organization
NPI issued: 2 Sep 2006
Record last updated: 1 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.