Provider Demographics
NPI:1427195668
Name:THE SANDERS CLINIC
Entity Type:Organization
Organization Name:THE SANDERS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRITCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-525-1438
Mailing Address - Street 1:6027 WALNUT GROVE RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2145
Mailing Address - Country:US
Mailing Address - Phone:901-525-1438
Mailing Address - Fax:901-521-0477
Practice Address - Street 1:6027 WALNUT GROVE RD
Practice Address - Street 2:SUITE 401
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2145
Practice Address - Country:US
Practice Address - Phone:901-525-1438
Practice Address - Fax:901-521-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3373417Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER