Provider Demographics
NPI:1902909252
Name:PRIORITY ONE MEDICAL, INC.
Entity Type:Organization
Organization Name:PRIORITY ONE MEDICAL, INC.
Other - Org Name:MEMPHIS MEDICAL REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CORTES
Authorized Official - Last Name:HOLLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:901-367-0811
Mailing Address - Street 1:8132 CORDOVA RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-6005
Mailing Address - Country:US
Mailing Address - Phone:901-367-0811
Mailing Address - Fax:901-367-9569
Practice Address - Street 1:8132 CORDOVA RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-6005
Practice Address - Country:US
Practice Address - Phone:901-367-0811
Practice Address - Fax:901-367-9569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN444540Medicare PIN
TN444540Medicare Oscar/Certification