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Organization
DAR SALUD CARE PLLC
Active
Organization
DAR SALUD CARE PLLC
Active
Other names
Dar Salud Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA FULLER MAML (BILLING AND CREDENTIALING MANAGER)
(901) 922-5951
Entity
Organization
Contact information
Practice address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
(901) 683-0024
(901) 683-0086
Mailing address
6074 APPLE TREE DR STE 10, MEMPHIS, TN 38115-0300
(901) 922-5951
(901) 922-5952
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
3336C0002X
Clinic Pharmacy
—
NULL
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519872
—
TN
01
—
2158680
PK
—
Enumeration date
10/24/2012
Last updated
04/06/2020
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