Organization
DARSALUD COMMUNITY CENTER INC
Active
Other names
LIFEDOC HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA FULLER MAML, CPC (BILLING AND CREDENTIALING MANAGER)
(901) 922-5951
Entity
Organization
Contact information
Practice address
6063 MOUNT MORIAH ROAD EXT STE 4, MEMPHIS, TN 38115-2665
(901) 531-8800
(901) 531-8801
Mailing address
6625 LENOX PARK DR STE 202, MEMPHIS, TN 38115-8200
(901) 922-5951
(901) 922-5952
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q051384
—
TN
Enumeration date
06/25/2019
Last updated
04/21/2026
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