Provider Demographics
NPI:1780009399
Name:FRAYSER MEDICAL CENTER
Entity Type:Organization
Organization Name:FRAYSER MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUGHRABIEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-358-0326
Mailing Address - Street 1:1750 FRAYSER BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-6439
Mailing Address - Country:US
Mailing Address - Phone:901-358-0326
Mailing Address - Fax:901-358-9010
Practice Address - Street 1:9349 PARKGATE DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-3599
Practice Address - Country:US
Practice Address - Phone:901-358-0326
Practice Address - Fax:901-358-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN044474261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center