Healthcare Provider Details

I. General information

NPI: 1811041502
Provider Name (Legal Business Name): BAPTIST MEMORIAL HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1618 HIGHWAY 51 S UNIT C
COVINGTON TN
38019-3635
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 901-476-0333
  • Fax:
Mailing address:
  • Phone: 901-476-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GREGORY M DUCKETT
Title or Position: SR VP/ CLO
Credential:
Phone: 901-227-5233