Provider Demographics
NPI:1043860448
Name:901 HEALTH, PLLC
Entity type:Organization
Organization Name:901 HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN ROCCO
Authorized Official - Middle Name:MACMILLAN
Authorized Official - Last Name:RODNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-831-6905
Mailing Address - Street 1:3068 COVINGTON PIKE STE 3
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5001
Mailing Address - Country:US
Mailing Address - Phone:901-831-6905
Mailing Address - Fax:901-364-6309
Practice Address - Street 1:3068 COVINGTON PIKE STE 3
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5001
Practice Address - Country:US
Practice Address - Phone:901-831-6905
Practice Address - Fax:901-364-6309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty