Provider Demographics
NPI:1275906067
Name:RESURRECTION ER, LLC
Entity Type:Organization
Organization Name:RESURRECTION ER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DONLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-271-9500
Mailing Address - Street 1:4095 AMERICAN WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-8339
Mailing Address - Country:US
Mailing Address - Phone:901-271-9500
Mailing Address - Fax:901-271-9501
Practice Address - Street 1:3000 GETWELL RD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-2205
Practice Address - Country:US
Practice Address - Phone:901-369-8602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESURRECTION HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty