MEDICARE: CONSUMER HOME HEALTHCARE AGENCY

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	3747A0650X	Attendant Care Provider		TN

General Provider Information

NPI Number	:	1912324674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSUMER HOME HEALTHCARE AGENCY

Provider Business Mailing Address
First Line	:	3340 POPLAR AVE STE 201
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-4680
Country	:	US
Telephone Number	:	901-323-6194
Fax Number	:	901-323-6194

Provider Business Practice Location Address
First Line	:	3340 POPLAR AVE STE 201
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-4680
Country	:	US
Telephone Number	:	901-323-6194
Fax Number	:	901-323-6194

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MICHELLE MUHAMMAD
Credential	:
Telephone Number	:	901-948-5948

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	03/19/2014

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