Provider Demographics
NPI:1205574621
Name:CORE ORDINATES
Entity type:Organization
Organization Name:CORE ORDINATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY A
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:RUGUARU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:901-679-8442
Mailing Address - Street 1:5606 FAIR CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2316
Mailing Address - Country:US
Mailing Address - Phone:901-679-8442
Mailing Address - Fax:
Practice Address - Street 1:1143 CULLY RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8502
Practice Address - Country:US
Practice Address - Phone:901-877-4017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-25
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service