Provider Demographics
NPI:1659838969
Name:MEDRIS, LLC
Entity Type:Organization
Organization Name:MEDRIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-942-7719
Mailing Address - Street 1:615 S COLLEGE ST FL 9
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3355
Mailing Address - Country:US
Mailing Address - Phone:704-942-7719
Mailing Address - Fax:
Practice Address - Street 1:615 S COLLEGE ST FL 9
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3355
Practice Address - Country:US
Practice Address - Phone:704-942-7719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health