Organization
FMSC COLLIERVILLE OPERATING COMPANY
Active
Other names
Collierville Health & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE M DUAY III C.P.A. (CHIEF FINANCIAL OFFICER)
(786) 888-3310
Entity
Organization
Contact information
Practice address
490 W POPLAR AVE, COLLIERVILLE, TN 38017-2538
(305) 892-1790
Mailing address
1055 NE 125TH ST, NORTH MIAMI, FL 33161-5804
(786) 888-3310
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
314000000
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744-0470
—
TN
Enumeration date
02/07/2006
Last updated
12/03/2009
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