Healthcare Provider Details

I. General information

NPI: 1689963415
Provider Name (Legal Business Name): UNITY HOME MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 S MENDENHALL RD
MEMPHIS TN
38117-5213
US

IV. Provider business mailing address

9087 POPLAR AVE SUITE 105
GERMANTOWN TN
38138-7846
US

V. Phone/Fax

Practice location:
  • Phone: 901-440-8339
  • Fax: 901-759-4119
Mailing address:
  • Phone: 901-759-1919
  • Fax: 901-759-4119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number07332/11.1
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1048
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3542
License Number StateTN

VIII. Authorized Official

Name: MR. BOB FOURNIER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 901-759-1919