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Organization
PRI-MED INCORPORATED
Active
Organization
PRI-MED INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX F GRAY (GENERAL MANAGEER)
(901) 624-5911
Entity
Organization
Contact information
Practice address
1918 EXETER RD, STE-2, GERMANTOWN, TN 38138-2970
(901) 624-5911
(901) 624-5637
Mailing address
1918 EXETER RD, STE-2, GERMANTOWN, TN 38138-2970
(901) 624-5911
(901) 624-5637
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454502
—
TN
01
—
158399
BETTER HEALTH PLAN
TN
01
—
32656
TLC FAMILY HEALTH PLANS
TN
01
—
4087579
BCBS-TN
TN
01
—
99663
BCBS-AR
AR
Enumeration date
08/09/2005
Last updated
08/22/2020
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