Healthcare Provider Details

I. General information

NPI: 1730138611
Provider Name (Legal Business Name): FMSC MEMPHIS OPERATING COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
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

2491 JOY LN
MEMPHIS TN
38114-6088
US

V. Phone/Fax

Practice location:
  • Phone: 901-743-7700
  • Fax: 901-743-7186
Mailing address:
  • Phone: 901-743-7700
  • Fax: 901-743-7186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number237
License Number StateTN

VIII. Authorized Official

Name: MR. DENNIS SARCAUGA
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 305-892-1790