Healthcare Provider Details

I. General information

NPI: 1982526463
Provider Name (Legal Business Name): PROFESSIONAL CARE SERVICES OF WEST TN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 LAKEVIEW RD
SOMERVILLE TN
38068-9744
US

IV. Provider business mailing address

1997 HIGHWAY 51 S 1997 HIGHWAY 51-S
COVINGTON TN
38019-3630
US

V. Phone/Fax

Practice location:
  • Phone: 844-727-2778
  • Fax: 901-476-2498
Mailing address:
  • Phone: 844-727-2778
  • Fax: 901-622-1648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY D GRIGGS
Title or Position: DIRECTOR OF HR AND CREDENTIALING
Credential: GRIGGS
Phone: 844-727-2778