1760780969 NPI number — MEMPHIS HEALTH CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760780969 NPI number — MEMPHIS HEALTH CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEMPHIS HEALTH CENTER, INC.
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:
1760780969
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
360 E EH CRUMP BLVD
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:
38126-5310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-261-2002
Provider Business Mailing Address Fax Number:
901-946-9262

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4940 HIGHWAY 57
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38066-5068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-261-7303
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/11/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARBER
Authorized Official First Name:
AISHA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING DIRECTOR
Authorized Official Telephone Number:
901-261-2025

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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