Healthcare Provider Details

I. General information

NPI: 1285557769
Provider Name (Legal Business Name): PRESTIGE HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3189 KIRBY WHITTEN RD STE 204C
BARTLETT TN
38134-2854
US

IV. Provider business mailing address

3189 KIRBY WHITTEN RD STE 204C
BARTLETT TN
38134-2854
US

V. Phone/Fax

Practice location:
  • Phone: 901-665-3131
  • Fax:
Mailing address:
  • Phone: 901-665-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERRIE KIMBRO JOHNSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 901-665-3131