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Organization
ICP TENNESSEE ACO BILLING LLC
Active
Organization
ICP TENNESSEE ACO BILLING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY THOMASON (AUTHORIZED OFFICIAL)
(501) 406-6180
Entity
Organization
Contact information
Practice address
5100 POPLAR AVE STE 2700, MEMPHIS, TN 38137-2700
(855) 498-6767
(479) 968-1673
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(855) 498-6767
(479) 968-1673
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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