Organization
LACEY RUNIT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORAYNE THOMAS (MANGAR)
(901) 288-0679
Entity
Organization
Contact information
Practice address
3759 LAKEVIEW RD, MEMPHIS, TN 38116-3919
(901) 288-0679
(901) 249-3391
Mailing address
3759 LAKEVIEW RD, MEMPHIS, TN 38116-3919
(190) 128-8067
(901) 249-3391
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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