Active NPI
Medical Center Pharmacy Inc
- Durable Medical Equipment & Medical Supplies
- Cleveland, TN
National Provider Identifier
1033277447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 0000000700
- Legal business name
- MEDICAL CENTER PHARMACY INC
- Practice address
- 2401 N Ocoee St
Cleveland, TN 37311-3853 - Phone
- (423) 476-5547
- Fax
- (423) 472-0125
- NPI assigned
- Dec 5, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Joe Moore
- Title
- Owner
- Phone
- (423) 476-5547
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0000000700 | TN | Primary |
Addresses
Primary practice location
2401 N Ocoee St
Cleveland, TN 37311-3853
Mailing address
PO Box 3240
Cleveland, TN 37320-3240
Phone (423) 476-5547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3524217 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930000144 | TN | DME Supplier - Pharmacy | 1850466004 | Practice locations: Cleveland, TN |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Medical Center Pharm THHC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Health Service Clinic/Center
- Cleveland, TN
- NPI 1497116529
-
- Community/Retail Pharmacy
- Cleveland, TN
- NPI 1841364379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1498694400000",
"number": "1033277447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3240",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373203240",
"telephone_number": "423-476-5547",
"fax_number": "423-472-0125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 N OCOEE ST",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373113853",
"telephone_number": "423-476-5547",
"fax_number": "423-472-0125"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL CENTER PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-05",
"last_updated": "2017-06-29",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "JOE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "423-476-5547",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TN",
"license": "0000000700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3524217",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.