Eagle Medical Staffing, LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

0247 Issued in TN

Legal business name

EAGLE MEDICAL STAFFING, LLC

Practice address

1175 Vickery LN
Cordova, TN 38016-0682

Phone

(901) 737-3990

Fax

(901) 737-9836

NPI assigned

May 8, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tamara Lashon Perry

Title

Administrator

Phone

(901) 737-3990

Specialties & licenses 1

Addresses

Tax ID family

Eagle Medical Satffing LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eagle Medical Satffing, LLC

  • In Home Supportive Care Agency
  • Cordova, TN
  • NPI 1295970663
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399507200000",
    "number": "1558772806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 VICKERY LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160682",
            "telephone_number": "901-737-3990",
            "fax_number": "901-737-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 VICKERY LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160682",
            "telephone_number": "901-737-3990",
            "fax_number": "901-737-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MEDICAL STAFFING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-08",
        "last_updated": "2014-05-08",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "LASHON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-737-3990"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TN",
            "license": "0247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Dunn
• Constance L Durbin, MD
• Abigail Ida Durham, MSW, LSSW
• Lasaundra Eafen
• Eagle Medical Satffing, LLC
• Eagle Systems Technology, Inc
• Aliyah Renae Easley, NP
• Lauren Edmiston
• Crystal Edmonds, RBT
• Nikita Edmonds, DNP, FNP-C

• Preferred Provider Organization in Cordova, TN
• Providers in Cordova, TN by specialty
• Preferred Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.