Provider Demographics
NPI:1073387148
Name:GERIATRICS & PALLIATIVE CARE PLLC
Entity Type:Organization
Organization Name:GERIATRICS & PALLIATIVE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-279-4360
Mailing Address - Street 1:943 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-7734
Mailing Address - Country:US
Mailing Address - Phone:901-279-4360
Mailing Address - Fax:
Practice Address - Street 1:7820 WALKING HORSE CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2143
Practice Address - Country:US
Practice Address - Phone:901-279-4360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty