MEDICARE: TENNESSEE HOME HEALTH AIDES

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1447693544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENNESSEE HOME HEALTH AIDES

Provider Business Mailing Address
First Line	:	5175 ELMORE RD. SUTIE 9
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134
Country	:	US
Telephone Number	:	901-314-5573
Fax Number	:

Provider Business Practice Location Address
First Line	:	5175 ELMORE RD STE 9
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-5629
Country	:	US
Telephone Number	:	901-314-5573
Fax Number	:

Authorized Official
Title or Position	:	CO OWNER
Name	:	SHNICE ISOM
Credential	:	C.N.A
Telephone Number	:	901-314-5573

Provider Enumeration Date	:	04/09/2013
Last Update Date	:	04/09/2013

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Directions to “TENNESSEE HOME HEALTH AIDES ” Practice Location

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