Provider Demographics
NPI:1922204585
Name:COMPLETE HEALTHCARE CENTER
Entity Type:Organization
Organization Name:COMPLETE HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:CMOM
Authorized Official - Phone:901-276-2357
Mailing Address - Street 1:1750 MADISON AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6492
Mailing Address - Country:US
Mailing Address - Phone:901-276-2357
Mailing Address - Fax:901-276-2359
Practice Address - Street 1:1750 MADISON AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6492
Practice Address - Country:US
Practice Address - Phone:901-276-2357
Practice Address - Fax:901-276-2359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3717056Medicaid
TN3164341OtherBCBSTN
TN1275601346OtherANGELA WATSON DO
TN1417005711OtherRALPH TAYLOR M D
TNCH8845OtherRAILROAD MEDICARE
TNH90588Medicare UPIN
TNCH8845OtherRAILROAD MEDICARE