Healthcare Provider Details

I. General information

NPI: 1699507434
Provider Name (Legal Business Name): HEART N SOUL HOSPICE MEMPHIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 LYNNFIELD RD STE 258
MEMPHIS TN
38119-5161
US

IV. Provider business mailing address

51 CENTURY BLVD STE 100
NASHVILLE TN
37214-3614
US

V. Phone/Fax

Practice location:
  • Phone: 678-333-7880
  • Fax:
Mailing address:
  • Phone: 678-333-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACY WOOD
Title or Position: COO
Credential:
Phone: 678-333-7880