Provider Demographics
NPI:1134561608
Name:CHANDLER&IRVING MEDICAL
Entity type:Organization
Organization Name:CHANDLER&IRVING MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-238-4453
Mailing Address - Street 1:1862 POPLAR CREST CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-4827
Mailing Address - Country:US
Mailing Address - Phone:901-238-4453
Mailing Address - Fax:901-683-4454
Practice Address - Street 1:1862 POPLAR CREST CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4827
Practice Address - Country:US
Practice Address - Phone:901-238-4453
Practice Address - Fax:901-683-4454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies