MEDICARE: CHRIST COMMUITY HEALTH SERVICES 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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1629213475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIST COMMUITY HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	2670 UNION AVENUE EXT STE 1000
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-4416
Country	:	US
Telephone Number	:	901-842-3160
Fax Number	:	901-260-8599

Provider Business Practice Location Address
First Line	:	2670 UNION AVENUE EXT STE 1000
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-4416
Country	:	US
Telephone Number	:	901-842-3160
Fax Number	:	901-260-8599

Authorized Official
Title or Position	:	CEO
Name	:	MR. TRACY MCDANIEL
Credential	:
Telephone Number	:	901-842-3160

Provider Enumeration Date	:	12/09/2008
Last Update Date	:	12/06/2024

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Directions to “CHRIST COMMUITY HEALTH SERVICES INC ” Practice Location

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