Provider Demographics
NPI:1427603554
Name:UNIVERSITY OF MEMPHIS
Entity Type:Organization
Organization Name:UNIVERSITY OF MEMPHIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM EXECUTIVE DIRECTOR PROCUREM
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-678-5348
Mailing Address - Street 1:4055 NORTH PARK LOOP
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38152
Mailing Address - Country:US
Mailing Address - Phone:901-678-3209
Mailing Address - Fax:901-678-5630
Practice Address - Street 1:4055 NORTH PARK LOOP
Practice Address - Street 2:SUITE 1000
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38152
Practice Address - Country:US
Practice Address - Phone:901-678-3209
Practice Address - Fax:901-678-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty