Provider Demographics
NPI:1386194843
Name:MCCULLEY ALLERGY SINUS & ASTHMA
Entity Type:Organization
Organization Name:MCCULLEY ALLERGY SINUS & ASTHMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHARREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-623-3323
Mailing Address - Street 1:2155 WEST ST
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3856
Mailing Address - Country:US
Mailing Address - Phone:901-623-3323
Mailing Address - Fax:901-623-3324
Practice Address - Street 1:2155 WEST ST
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3856
Practice Address - Country:US
Practice Address - Phone:901-623-3323
Practice Address - Fax:901-623-3324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-09
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty