Mack, Irene

Mack, Irene is an individual health care provider with primary practice located at 1331 Union Ave Suite 1226, Memphis TN 38104-3513. She recently has only one registered license in Nursing Service Related Providers / Homemaker, which is considered as her primary health care specialty. Mack, Irene can be contacted via phone (901) 726-5888.

Contact Information

Primary practice address
1331 Union Ave Suite 1226 Memphis TN 38104-3513
Fax: (901) 726-6888
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Homemaker 376J00000X 253Z00000X Arkansas

Profile Details

NPI number 1497038699
LBN Legal business name Mack, Irene
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2011
Last updated Oct 29th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497038699 NPPES
Tennessee MEDICAID H445614
Tennessee MEDICAID 184245732

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