MEDICARE: MEMORIAL MANAGEMENT INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1518423904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL MANAGEMENT INC

Provider Business Mailing Address
First Line	:	PO BOX 5009
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37024-5009
Country	:	US
Telephone Number	:	615-221-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3331 W DEYOUNG ST STE 201
Second Line	:
City	:	MARION
State	:	IL
Zip	:	62959-5897
Country	:	US
Telephone Number	:	615-221-1400
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SOPHIA ARWOOD
Credential	:
Telephone Number	:	615-221-1400

Provider Enumeration Date	:	02/11/2019
Last Update Date	:	02/11/2019

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