=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972425577
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROFESSIONAL CARE SERVICES OF WEST TN INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2026
-----------------------------------------------------
Last Update Date | 07/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1997 HIGHWAY 51 S
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38019-3630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-727-2778
-----------------------------------------------------
Fax | 901-476-2498
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1997 HIGHWAY 51 S
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38019-3630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-727-2778
-----------------------------------------------------
Fax | 901-476-2498
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | EMILY D GRIGGS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 901-622-1648
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------