Provider Demographics
NPI:1467075291
Name:ESSENTIAL HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ESSENTIAL HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-375-4488
Mailing Address - Street 1:1198 STAGE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-7712
Mailing Address - Country:US
Mailing Address - Phone:850-375-4488
Mailing Address - Fax:850-254-7906
Practice Address - Street 1:1198 STAGE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-7712
Practice Address - Country:US
Practice Address - Phone:850-375-4488
Practice Address - Fax:850-254-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies