Provider Demographics
NPI:1891030946
Name:CHERRY HILL RADIOLOGY PLLC
Entity Type:Organization
Organization Name:CHERRY HILL RADIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-753-8370
Mailing Address - Street 1:PO BOX 1000 DEPT 219
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0129
Mailing Address - Country:US
Mailing Address - Phone:901-753-8370
Mailing Address - Fax:901-756-0714
Practice Address - Street 1:401 REDFIELD DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-8555
Practice Address - Country:US
Practice Address - Phone:901-753-8370
Practice Address - Fax:901-756-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD000000417672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty