Provider Demographics
NPI:1902278179
Name:UNIVERSITY OF TENNESSEE
Entity Type:Organization
Organization Name:UNIVERSITY OF TENNESSEE
Other - Org Name:DURABLE MEDICAL EQUIPMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE CHANCELLOR/CHIEF FINANCIAL OFF
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-448-5523
Mailing Address - Street 1:875 UNION AVE
Mailing Address - Street 2:ROOMS C211B
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-0001
Mailing Address - Country:US
Mailing Address - Phone:901-448-2801
Mailing Address - Fax:901-448-7104
Practice Address - Street 1:875 UNION AVE.
Practice Address - Street 2:ROOMS S510B
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-448-7196
Practice Address - Fax:901-448-7104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF TENNESSEE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty
No229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Multi-Specialty