Provider Demographics
NPI:1518901396
Name:TAPESTRY CONCEPTS, LLC
Entity Type:Organization
Organization Name:TAPESTRY CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-312-3608
Mailing Address - Street 1:2723 SUMMER OAKS DR.
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2858
Mailing Address - Country:US
Mailing Address - Phone:901-312-3608
Mailing Address - Fax:901-322-3496
Practice Address - Street 1:2723 SUMMER OAKS DR.
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2858
Practice Address - Country:US
Practice Address - Phone:901-312-3608
Practice Address - Fax:901-322-3496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN105002502332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807416800Medicaid
TN1455016Medicaid
MS06993111OtherMEDICAL EQUIP SUPPLY PERM
PA1015492490001Medicaid
IN200808490AMedicaid
OH2643778Medicaid
TX1777146Medicaid
WA9061607Medicaid
SCDE2727Medicaid
VA010268443Medicaid
UT=========001Medicaid
IN200808490AMedicaid