| Christ Community Health Services Inc. | |
|
1211 Union Ave Suite 200 Memphis TN 38104-6638 | |
| (901) 271-0330 | |
| (901) 271-0399 |
| Full Name | Christ Community Health Services Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1211 Union Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Burt Waller (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9012608551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christ Community Health Services Inc. 2595 Central Ave Memphis TN 38104-5905 Ph: (901) 260-8551 | Christ Community Health Services Inc. 1211 Union Ave Suite 200 Memphis TN 38104-6638 Ph: (901) 271-0330 |
| NPI Number | 1972892727 |
|---|---|
| Provider Enumeration Date | 04/01/2011 |
| Last Update Date | 01/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972892727 | 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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