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General NPI Number Information
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NPI Number | 1780685750
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Entity Type | Organization
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Legal Business Name | SHELBY COUNTY HEALTH CARE CORPORATION
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 877 JEFFERSON AVE
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City | MEMPHIS
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State | TN
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Zip | 38103-2807
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Country | US
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Telephone | 901-545-8336
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Fax | 901-545-8122
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Provider Business Mailing Address
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Address Line | 877 JEFFERSON AVE ATTN: PROVIDER ENROLLMENT
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City | MEMPHIS
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State | TN
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Zip | 38103-2807
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Country | US
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Telephone | 901-545-6286
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Fax | 901-545-8122
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JAMES PROCTOR
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Credential |
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Telephone | 901-545-8254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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