MEDICARE: SELECT SERVICES OF MEMPHIS 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1518658145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT SERVICES OF MEMPHIS INC

Provider Business Mailing Address
First Line	:	3540 SUMMER AVE STE 402
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-3633
Country	:	US
Telephone Number	:	901-503-9817
Fax Number	:	901-236-0391

Provider Business Practice Location Address
First Line	:	3540 SUMMER AVE STE 402
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38122-3633
Country	:	US
Telephone Number	:	901-503-9817
Fax Number	:	901-236-0391

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANGELIA SKIPPER
Credential	:
Telephone Number	:	901-503-9817

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	09/06/2023

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