Provider Demographics
NPI:1972261261
Name:MEMPHIS URGENT CARE #2 LLC
Entity type:Organization
Organization Name:MEMPHIS URGENT CARE #2 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, CFO TPR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-2532
Mailing Address - Street 1:4562 POPLAR AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-7515
Mailing Address - Country:US
Mailing Address - Phone:901-329-8990
Mailing Address - Fax:901-425-9496
Practice Address - Street 1:4562 POPLAR AVE STE 109
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-7515
Practice Address - Country:US
Practice Address - Phone:901-329-8990
Practice Address - Fax:901-425-9496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies