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General NPI Number Information
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NPI Number | 1053613851
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Entity Type | Organization
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Legal Business Name | CHRIST COMMUNITY HEALTH SERVICES INC
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 5366 WINCHESTER RD 5366 MENDENHALL MALL
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City | MEMPHIS
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State | TN
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Zip | 38115-4565
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Country | US
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Telephone | 901-271-6170
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Fax | 901-271-6180
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Provider Business Mailing Address
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Address Line | 2670 UNION AVENUE EXT STE 1000
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City | MEMPHIS
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State | TN
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Zip | 38112-4416
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Country | US
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Telephone | 901-842-3160
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Fax | 901-260-8598
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Authorized Official
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Title or Position | CEO
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Name | TRACY MCDANIEL
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Credential |
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Telephone | 901-842-3160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 4801
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License Number State | TN
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