Provider Demographics
NPI:1053367094
Name:ELDER CARE, INC.
Entity type:Organization
Organization Name:ELDER CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-398-2167
Mailing Address - Street 1:3318 MILLBRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-3624
Mailing Address - Country:US
Mailing Address - Phone:901-398-2167
Mailing Address - Fax:901-398-9337
Practice Address - Street 1:3318 MILLBRANCH RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-3624
Practice Address - Country:US
Practice Address - Phone:901-398-2167
Practice Address - Fax:901-398-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000224251E00000X
TNPSS0000000021251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0447525Medicaid
TN197044OtherGENTIVA
TN53755OtherOMNICARE
TN53953OtherTN CARE SELECT
TN33ELDCAR220001OtherINFUSION PARTNERS
TN1078980OtherACM-UNITED HEALTHCARE
TN21059OtherTLC
TN53953OtherBLUE CROSS BLUE SHIELD
TN447525OtherPHARMATHERA
TN117212OtherBETTER HEALTH PLAN
TN447525OtherAHCA
TNV0000909120OtherT.E.I.S.
TN0447525Medicaid
TN447525OtherPHARMATHERA
TN=========OtherCIGNA
TN=========OtherINTRACORP
TN=========OtherPREMIER BEHAVIORAL SYSTEM