Provider Demographics
NPI:1306890751
Name:BAPTIST MEMORIAL REGIONAL REHABILITATIVE SERVICES
Entity type:Organization
Organization Name:BAPTIST MEMORIAL REGIONAL REHABILITATIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRALKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-757-3439
Mailing Address - Street 1:7950 CLUB CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-8667
Mailing Address - Country:US
Mailing Address - Phone:901-754-0384
Mailing Address - Fax:
Practice Address - Street 1:7950 CLUB CENTER DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-8667
Practice Address - Country:US
Practice Address - Phone:901-754-0384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4064896OtherBCTN PROVIDER NUMBER
TN446605Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER