| Beloved Medical, Llc | |
|
8045 Club Pkwy Cordova TN 38016-5977 | |
| (901) 249-0847 | |
| (833) 673-0465 |
| Full Name | Beloved Medical, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 8045 Club Pkwy, Cordova, Tennessee |
| Authorized Official Name and Position | Amy Brewington (CFO) |
| Authorized Official Contact | 9012490847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beloved Medical, Llc 8045 Club Pkwy Cordova TN 38016-5977 Ph: (901) 249-0847 | Beloved Medical, Llc 8045 Club Pkwy Cordova TN 38016-5977 Ph: (901) 249-0847 |
| NPI Number | 1699210369 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8123393766 |
|---|---|
| Medicare Enrollment ID | O20171006000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699210369 | NPI | - | NPPES |
| 1518092 | Medicaid | TN | |
| Q028486 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Tennessee) | Primary |
| 207V00000X | Obstetrics & Gynecology | (Tennessee) | Secondary |
| Provider Name | Ikechukwu U Emereuwaonu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164664066 PECOS PAC ID: 6709926413 Enrollment ID: I20100830000259 |
| Provider Name | Oluwayemisi O Emereuwaonu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700197530 PECOS PAC ID: 0941435804 Enrollment ID: I20131030001272 |
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