Organization
PRIVATE SENIOR PROVIDERS ETP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY SHERMAN GILLESPIE HOME HEALTH AIDE (OWNER)
(901) 315-8619
Entity
Organization
Contact information
Practice address
234 PANDORA ST, CO/BRENDA THOMPSON, MEMPHIS, TN 38117-2855
(901) 315-8619
(901) 763-2907
Mailing address
PO BOX 770193, MEMPHIS, TN 38177-0193
(901) 315-8619
(901) 761-2907
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/02/2006
Last updated
08/01/2007
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