MEDICARE: INTERIM HEALTHCARE 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	251E00000X	Home Health Agency	228	TN

General Provider Information

NPI Number	:	1851463533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF MEMPHIS, INC.

Provider Business Mailing Address
First Line	:	2620 THOUSAND OAKS BLVD
Second Line	:	SUITE 1400
City	:	MEMPHIS
State	:	TN
Zip	:	38118-2472
Country	:	US
Telephone Number	:	901-761-5000
Fax Number	:	901-767-0972

Provider Business Practice Location Address
First Line	:	2620 THOUSAND OAKS BLVD
Second Line	:	SUITE 1400
City	:	MEMPHIS
State	:	TN
Zip	:	38118-2472
Country	:	US
Telephone Number	:	901-761-5000
Fax Number	:	901-767-0972

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHEILA VARADI
Credential	:
Telephone Number	:	901-761-5000

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	04/19/2011

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