Healthcare Provider Details

I. General information

NPI: 1336676014
Provider Name (Legal Business Name): ROKIE HUMU ALGHALI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 LEXUS LN
MEMPHIS TN
38119-9006
US

IV. Provider business mailing address

5865 RIDGEWAY CENTER PKWY STE 300
MEMPHIS TN
38120-4014
US

V. Phone/Fax

Practice location:
  • Phone: 901-849-0947
  • Fax:
Mailing address:
  • Phone: 901-849-0947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: