Provider Demographics
NPI:1699941195
Name:METHODIST HEALTHCARE COMMUNITY CARE ASSOCIATES
Entity type:Organization
Organization Name:METHODIST HEALTHCARE COMMUNITY CARE ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULOY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-516-1476
Mailing Address - Street 1:6400 SHELBY VIEW DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7659
Mailing Address - Country:US
Mailing Address - Phone:901-516-1489
Mailing Address - Fax:901-380-8081
Practice Address - Street 1:6400 SHELBY VIEW DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7659
Practice Address - Country:US
Practice Address - Phone:901-516-1489
Practice Address - Fax:901-380-8081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HEALTHCARE COMMUNITY CARE ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health