Provider Demographics
NPI:1255953956
Name:ENDO 247 LLC
Entity type:Organization
Organization Name:ENDO 247 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERECHI
Authorized Official - Middle Name:C
Authorized Official - Last Name:OGWO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-744-3362
Mailing Address - Street 1:875 W POPLAR AVE STE 23
Mailing Address - Street 2:#102
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2598
Mailing Address - Country:US
Mailing Address - Phone:901-744-3362
Mailing Address - Fax:901-744-7658
Practice Address - Street 1:5220 PARK AVE STE 202
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3549
Practice Address - Country:US
Practice Address - Phone:901-744-3362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ057155Medicaid