Healthcare Provider Details

I. General information

NPI: 1689646150
Provider Name (Legal Business Name): FMSC MEMPHIS OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2491 JOY LN
MEMPHIS TN
38114-6088
US

IV. Provider business mailing address

1680 MICHIGAN AVE STE 736
MIAMI BEACH FL
33139-2551
US

V. Phone/Fax

Practice location:
  • Phone: 305-892-1790
  • Fax:
Mailing address:
  • Phone: 305-892-1790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateTN

VIII. Authorized Official

Name: MR. NELSON ROBAINA JR.
Title or Position: VP OF REIMBURSMENTS
Credential: B.S.
Phone: 305-892-1790