Provider Demographics
NPI:1336508407
Name:ERX PLUS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ERX PLUS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVRNJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-777-1300
Mailing Address - Street 1:9724 KINGSTON PIKE STE 208
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3389
Mailing Address - Country:US
Mailing Address - Phone:865-777-1300
Mailing Address - Fax:
Practice Address - Street 1:5189 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9524
Practice Address - Country:US
Practice Address - Phone:865-777-1300
Practice Address - Fax:865-777-1929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty