Provider Demographics
NPI:1144394289
Name:ADVANCED PRIMARY CARE INC
Entity Type:Organization
Organization Name:ADVANCED PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEECH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-363-1945
Mailing Address - Street 1:5983 APPLE TREE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2639
Mailing Address - Country:US
Mailing Address - Phone:901-363-1945
Mailing Address - Fax:901-363-1926
Practice Address - Street 1:5983 APPLE TREE DRIVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2639
Practice Address - Country:US
Practice Address - Phone:901-363-1945
Practice Address - Fax:901-363-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3718320Medicare ID - Type Unspecified