Southern Cardiovascular Pllc

LBN: Southern Cardiovascular Pllc
Southern Cardiovascular Pllc is an health care organization with primary practice located at 6401 Poplar Ave Ste 410 , Memphis TN 38119. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Southern Cardiovascular Pllc can be contacted via phone (901) 259-2718, or through Ellichman, Jonathan Joe via phone (901) 259-2718.

Contact Information

Primary practice address
6401 Poplar Ave Ste 410 Memphis TN 38119
Phone: (901) 259-2718
Fax: (901) 259-1123
Website:
Map and Directions
Authorized official contact:
Name: Ellichman, Jonathan Joe Doctor of Medicine (MD)
Phone: (901) 259-2718

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1447415104
LBN Legal business name Southern Cardiovascular Pllc
DBA Doing business as
Authorized official Ellichman, Jonathan Joe Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2008
Last updated Aug 15th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447415104 NPPES
Tennessee MEDICAID 1526038

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