Provider Demographics
NPI:1477193399
Name:ANOVORX MANUFACTURER SERVICES, LLC
Entity Type:Organization
Organization Name:ANOVORX MANUFACTURER SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-201-5470
Mailing Address - Street 1:1710 SHELBY OAKS DR N STE 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7403
Mailing Address - Country:US
Mailing Address - Phone:901-612-3281
Mailing Address - Fax:901-201-5465
Practice Address - Street 1:1710 SHELBY OAKS DR N STE 3
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7403
Practice Address - Country:US
Practice Address - Phone:901-612-3281
Practice Address - Fax:901-201-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management