Provider Demographics
NPI:1104297639
Name:DEPENDABLE CARE LLC
Entity type:Organization
Organization Name:DEPENDABLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-252-0960
Mailing Address - Street 1:PO BOX 18363
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38181-0363
Mailing Address - Country:US
Mailing Address - Phone:662-252-0960
Mailing Address - Fax:662-510-0180
Practice Address - Street 1:3960 KNIGHT ARNOLD RD
Practice Address - Street 2:STE 115
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-3035
Practice Address - Country:US
Practice Address - Phone:662-252-0960
Practice Address - Fax:662-510-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20147363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty