| Peabody Family Care, Pc | |
|
1325 Eastmoreland Avenue Suite 150 Memphis TN 38104-3519 | |
| (901) 725-0648 | |
| (901) 725-1037 |
| Full Name | Peabody Family Care, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1325 Eastmoreland Avenue, Memphis, Tennessee |
| Authorized Official Name and Position | Pam Alexander (ADMINISTRATOR) |
| Authorized Official Contact | 9017565565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peabody Family Care, Pc Po Box 1000 Dept 297 Memphis TN 38148-0001 Ph: (901) 725-0648 | Peabody Family Care, Pc 1325 Eastmoreland Avenue Suite 150 Memphis TN 38104-3519 Ph: (901) 725-0648 |
| NPI Number | 1023057437 |
|---|---|
| Provider Enumeration Date | 06/05/2006 |
| Last Update Date | 10/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023057437 | NPI | - | NPPES |
| 09015606 | Medicaid | MS | |
| 3723978 | Medicaid | TN | |
| CG9962 | Other | RAILROAD MEDICARE | |
| 8P078 | Other | AR | BCBS AR-GROUP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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