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General NPI Number Information
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NPI Number | 1700775871
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Entity Type | Organization
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Legal Business Name | FULFILLMENT HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 2600 POPLAR AVE STE 301
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City | MEMPHIS
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State | TN
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Zip | 38112-3835
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Country | US
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Telephone | 901-496-8579
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Fax | 901-677-1608
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Provider Business Mailing Address
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Address Line | 2600 POPLAR AVE STE 301
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City | MEMPHIS
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State | TN
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Zip | 38112-3835
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Country | US
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Telephone | 901-496-8579
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Fax | 901-677-1608
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KAMESHIA SHANTEL MCGEE
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Credential |
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Telephone | 901-496-8579
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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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