1598769374 NPI number — PRESSURE MANAGEMENT RESOURCES, LLC

Table of content: (NPI 1598769374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598769374 NPI number — PRESSURE MANAGEMENT RESOURCES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRESSURE MANAGEMENT RESOURCES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PRESSURE MANAGEMENT RESOUCES, LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598769374
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7531 BARTLETT CORPORATE CV E STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38133-8951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-396-5211
Provider Business Mailing Address Fax Number:
901-396-5221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7531 BARTLETT CORPORATE CV E STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38133-8951
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-396-5211
Provider Business Practice Location Address Fax Number:
901-396-5221
Provider Enumeration Date:
06/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CASON
Authorized Official First Name:
BILL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
901-396-5211

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0000000472 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 135557716 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00440551 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1152170 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001529495 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1452394 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3122249 . This is a "BCBSTN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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