| Christ Community Health Services Inc | |
|
2861 Broad Avenue Christ Community Health Services,inc Memphis TN 38112 | |
| (901) 260-8450 | |
| (901) 325-6469 |
| Full Name | Christ Community Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2861 Broad Avenue, Memphis, Tennessee |
| Authorized Official Name and Position | Burt Waller (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9012608551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christ Community Health Services Inc 2595 Central Ave Christ Community Health Services,inc Memphis TN 38104-5905 Ph: (901) 260-8551 | Christ Community Health Services Inc 2861 Broad Avenue Christ Community Health Services,inc Memphis TN 38112 Ph: (901) 260-8450 |
| NPI Number | 1952562696 |
|---|---|
| Provider Enumeration Date | 06/24/2008 |
| Last Update Date | 01/23/2012 |
| Medicare PECOS PAC ID | 3870402084 |
|---|---|
| Medicare Enrollment ID | O20030610000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952562696 | NPI | - | NPPES |
| 3707256 | Other | TN | MEDICAID GROUP NUMBER |
| 3707256 | Other | TN | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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