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1568564425
PRIVATE SENIOR PROVIDERS ETP LLC
MEMPHIS, TN
NPI
1568564425
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Entity Type
Organization
Authorized Contact
NANCY SHERMAN GILLESPIE
Owner
901-315-8619
Organization Subpart ?
No
Primary Taxonomy
302R00000X Health Maintenance Organization
Enumeration Date
2006-09-02
Last Update Date
2007-08-01
Business Address
PRIVATE SENIOR PROVIDERS ETP LLC
234 PANDORA ST CO/BRENDA THOMPSON
MEMPHIS, TN 38117-2855
Phone number: 901-315-8619
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Mailing Address
PRIVATE SENIOR PROVIDERS ETP LLC
PO BOX 770193
MEMPHIS, TN 38177-0193
Phone number: 901-315-8619
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