MEDICARE: ANOINTED CROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1316566490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANOINTED CROWN

Provider Business Mailing Address
First Line	:	2696 CENTRAL TER
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-1614
Country	:	US
Telephone Number	:	863-840-3180
Fax Number	:

Provider Business Practice Location Address
First Line	:	2696 CENTRAL TER
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-1614
Country	:	US
Telephone Number	:	863-840-3180
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MS. MEESHA RENEE MUNNINGS
Credential	:	M.ED.L
Telephone Number	:	863-840-3180

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	04/09/2020

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Directions to “ANOINTED CROWN ” Practice Location

Language	Start Address	Practice Location

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