Organization
STF MEDICAL & MANAGEMENT GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR OMOTAYO OMOTUNDE (PRESIDENT)
(901) 937-7641
Entity
Organization
Contact information
Practice address
1049 CRESTHAVEN RD, MEMPHIS, TN 38119-3833
(901) 761-9798
(901) 761-9799
Mailing address
1049 CRESTHAVEN RD, MEMPHIS, TN 38119-3833
(901) 761-9798
(901) 761-9799
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000912
TN
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455183
—
TN
Enumeration date
11/20/2006
Last updated
06/21/2013
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