1124262183 NPI number — HOMECARE COMFORTABLE SOLUTIONS

Table of content: MELISSA ANN ARDIZZONE MD (NPI 1649965757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124262183 NPI number — HOMECARE COMFORTABLE SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOMECARE COMFORTABLE SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124262183
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3633 CHESTERWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38118-6436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-603-7327
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3633 CHESTERWOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38118-6436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-603-7327
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
VENZUAY
Authorized Official Middle Name:
NANNETTE
Authorized Official Title or Position:
OWNER/CAREGIVER
Authorized Official Telephone Number:
901-603-7327

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  109002357 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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