1922258946 NPI number — MEMORIAL HEALTH PARTNERS FOUNDATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922258946 NPI number — MEMORIAL HEALTH PARTNERS FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMORIAL HEALTH PARTNERS FOUNDATION
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:
Provider Other Organization Name Type Code:
6
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:
1922258946
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 116638
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30368-6638
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-495-4912
Provider Business Mailing Address Fax Number:
423-495-4970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4700 BATTLEFIELD PKWY
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
RINGGOLD
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30736-5166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-861-4990
Provider Business Practice Location Address Fax Number:
706-861-9405
Provider Enumeration Date:
09/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
REGISTER
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
423-495-6870

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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