Provider Demographics
NPI:1447585492
Name:ACCESS P&O CENTRAL FAB
Entity Type:Organization
Organization Name:ACCESS P&O CENTRAL FAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:LARKISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-643-2071
Mailing Address - Street 1:1089 EASTMORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3334
Mailing Address - Country:US
Mailing Address - Phone:901-525-9378
Mailing Address - Fax:
Practice Address - Street 1:1089 EASTMORELAND AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3334
Practice Address - Country:US
Practice Address - Phone:901-525-9378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier