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1871802082
NEW MEXICO PHS LLC
MEMPHIS, TN
NPI
1871802082
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Entity Type
Organization
Authorized Contact
THERESA NICHOLAS
Credentialing Manager
901-261-4858
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2010-10-05
Last Update Date
2010-10-05
Business Address
NEW MEXICO PHS LLC
9155 CRESTWYN HILLS DR
MEMPHIS, TN 38125-8501
Phone number: 901-261-4848
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Mailing Address
NEW MEXICO PHS LLC
6565 AMERICAS PKWY NE STE 200
ALBUQUERQUE, NM 87110-8172
Phone number:
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