Organization
GETWELL COMMUNITY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEO F. ROURKE JR. A.R.N.P. (NURSE PRACTITIONER)
(901) 369-4900
Entity
Organization
Contact information
Practice address
3055 WATSON ST, MEMPHIS, TN 38118-3011
(901) 369-4900
Mailing address
3055 WATSON ST, MEMPHIS, TN 38118-3011
(901) 369-4900
(901) 365-3555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26642
TN
363LF0000X
Family Nurse Practitioner
Primary
APN0000006732
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3736618
FEDERAL MEDICARE NUMBER
TN
Enumeration date
01/09/2007
Last updated
08/23/2007
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