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1174107338
ICP TENNESSEE ACO BILLING LLC
MEMPHIS, TN
NPI
1174107338
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Entity Type
Organization
Authorized Contact
RODNEY THOMASON
Authorized Official
501-406-6180
Organization Subpart ?
No
Primary Taxonomy
364S00000X Clinical Nurse Specialist
Enumeration Date
2021-05-12
Last Update Date
2021-05-12
Business Address
ICP TENNESSEE ACO BILLING LLC
5100 POPLAR AVE STE 2700
MEMPHIS, TN 38137-2700
Phone number: 855-498-6767
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Mailing Address
ICP TENNESSEE ACO BILLING LLC
PO BOX 9178
RUSSELLVILLE, AR 72811-9178
Phone number: 855-498-6767
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