Healthcare Provider Details

I. General information

NPI: 1679003750
Provider Name (Legal Business Name): CARE ONE MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 UNION AVE STE 1000
MEMPHIS TN
38104-3513
US

IV. Provider business mailing address

4191 BLACKSMITH CV
MEMPHIS TN
38125-2611
US

V. Phone/Fax

Practice location:
  • Phone: 901-679-0509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number95073
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2278S1500X
TaxonomySNF/Subacute Care Certified Respiratory Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number3995
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT FARMER
Title or Position: CHIEF OPERATING OFFICER
Credential: RCP
Phone: 901-679-0509