Provider Demographics
NPI:1386709871
Name:METHODIST HEALTHCARE - MEMPHIS HOSPITALS
Entity type:Organization
Organization Name:METHODIST HEALTHCARE - MEMPHIS HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-516-0696
Mailing Address - Street 1:848 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2816
Mailing Address - Country:US
Mailing Address - Phone:901-287-5437
Mailing Address - Fax:
Practice Address - Street 1:848 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2816
Practice Address - Country:US
Practice Address - Phone:901-287-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST LE BONHEUR HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-26
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000109282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC10023AMedicaid
GA000210999XMedicaid
MA1004689Medicaid
TX107841201Medicaid
ID002126300Medicaid
WV0173404001Medicaid
IN200115850AMedicaid
AKHS377OPMedicaid
MT4102015Medicaid
KS100106430 AMedicaid
SC10340BMedicaid
MN139248400Medicaid
NJ4216202Medicaid
WI80490400Medicaid
PA00934732Medicaid
OH0185366Medicaid
PA00934732Medicaid
IN200115850AMedicaid