Provider Demographics
NPI:1922085778
Name:SOUTH PARKWAY ASSOCIATES, L.P.
Entity Type:Organization
Organization Name:SOUTH PARKWAY ASSOCIATES, L.P.
Other - Org Name:PARKWAY HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-992-0441
Mailing Address - Street 1:200 S PARKWAY W
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-1645
Mailing Address - Country:US
Mailing Address - Phone:901-942-7456
Mailing Address - Fax:901-942-9839
Practice Address - Street 1:200 S PARKWAY W
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-1645
Practice Address - Country:US
Practice Address - Phone:901-942-7456
Practice Address - Fax:901-942-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000349314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN744-0582Medicaid
TN044-5387Medicaid
TN044-5387Medicaid