Provider Demographics
NPI:1497821185
Name:WOMENS CARE CENTER OF MEMPHIS,MPLLC
Entity Type:Organization
Organization Name:WOMENS CARE CENTER OF MEMPHIS,MPLLC
Other - Org Name:D/B/A RUCH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-682-0630
Mailing Address - Street 1:7705 POPLAR AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3930
Mailing Address - Country:US
Mailing Address - Phone:901-682-0630
Mailing Address - Fax:901-312-9696
Practice Address - Street 1:7705 POPLAR AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3930
Practice Address - Country:US
Practice Address - Phone:901-682-0630
Practice Address - Fax:901-312-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3714911Medicare ID - Type Unspecified