SOUTHEAST MENTAL HEALTH CENTER INC NPI 1063575165

NPI Information

SOUTHEAST MENTAL HEALTH CENTER, INC is a clinic pharmacy pharmacy in Memphis, TN. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. SOUTHEAST MENTAL HEALTH CENTER, INC NPI is 1063575165. The provider is registered as an organization entity type.

The provider's business location address is:

2579 DOUGLASS AVE
SOUTHEAST MENTAL HEALTH CENTER
MEMPHIS, TN
ZIP 38114-532
Phone: (901) 369-1484
Fax: (901) 312-7572

The provider's authorized official is Owen Eugene Lawrence .
The authorized official title is Executive Director and has the following contact phone number (901) 369-1420.

The enumeration date for this NPI number is 12/19/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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