Healthcare Provider Details

I. General information

NPI: 1760898415
Provider Name (Legal Business Name): LP MEMPHIS V, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6025 PRIMACY PKWY
MEMPHIS TN
38119-5763
US

IV. Provider business mailing address

12201 BLUEGRASS PKWY
LOUISVILLE KY
40299-2361
US

V. Phone/Fax

Practice location:
  • Phone: 901-767-1040
  • Fax: 901-685-7362
Mailing address:
  • Phone: 502-568-7800
  • Fax: 502-259-0183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN HARRISON
Title or Position: CFO
Credential:
Phone: 502-568-7800