Organization
CENTRAL MEMPHIS REGIONAL PET IMAGING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK GABRIEL (PRINCIPAL)
(317) 634-2222
Entity
Organization
Contact information
Practice address
1388 MADISON AVE, MEMPHIS, TN 38104-2327
(901) 276-6413
(901) 276-3838
Mailing address
PO BOX 2121, MEMPHIS, TN 38159-0001
(901) 276-6413
(901) 276-3838
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
NA
TN
Other
Enumeration date
12/05/2005
Last updated
08/22/2020
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