| Iac Associates Pllc | |
|
6401 Poplar Ave Ste 500 Memphis TN 38119-4808 | |
| (901) 746-9438 | |
| (941) 746-9331 |
| Full Name | Iac Associates Pllc |
|---|---|
| Speciality | Counselor |
| Location | 6401 Poplar Ave Ste 500, Memphis, Tennessee |
| Authorized Official Name and Position | Marina Jo Mahoney (VP OF RCM AND PAYOR RELATIONS) |
| Authorized Official Contact | 9515602877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iac Associates Pllc 3312 Teasley Ln Ste 100 Denton TX 76210-8311 Ph: (940) 360-4245 | Iac Associates Pllc 6401 Poplar Ave Ste 500 Memphis TN 38119-4808 Ph: (901) 746-9438 |
| NPI Number | 1487126272 |
|---|---|
| Provider Enumeration Date | 12/18/2018 |
| Last Update Date | 06/10/2024 |
| Certification Date | 06/10/2024 |
| Medicare PECOS PAC ID | 5496181133 |
|---|---|
| Medicare Enrollment ID | O20200128003261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487126272 | NPI | - | NPPES |
| Q048108 | Medicaid | TN | |
| 03401509 | Medicaid | MS |
| Provider Name | Shawn Hamm |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1821330895 PECOS PAC ID: 2264651397 Enrollment ID: I20171024003089 |
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