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General NPI Number Information
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NPI Number | 1497316111
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Entity Type | Organization
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Legal Business Name | COMMONS MID-SOUTH HOME CARE
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 5395 FOX PLAZA DR STE 101J
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City | MEMPHIS
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State | TN
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Zip | 38115-1516
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Country | US
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Telephone | 901-480-8606
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Fax | 901-249-8651
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Provider Business Mailing Address
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Address Line | 5395 FOX PLAZA DR STE 101J
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City | MEMPHIS
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State | TN
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Zip | 38115-1516
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Country | US
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Telephone | 901-480-8606
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Fax | 901-249-8651
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONITA PATRICK
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Credential |
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Telephone | 901-480-8606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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