Organization Active NPI

First Pharmacy Services of Tennessee LLC

  • Long Term Care Pharmacy
  • Memphis, TN
National Provider Identifier
1063693067
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
00004454 Issued in TN
Legal business name
FIRST PHARMACY SERVICES OF TENNESSEE LLC
Doing business as
First Pharmacy Services of Tennessee LLC
Practice address
1087 Alice Ave
Memphis, TN 38106-6543
Phone
(901) 946-1375
Fax
(901) 946-1377
NPI assigned
Nov 19, 2007
Last updated
Dec 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denise Pratt, D PH
Title
VP
Phone
(901) 946-1375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 00004454 TN Primary

Addresses

Primary practice location

1087 Alice Ave
Memphis, TN 38106-6543

Mailing address

PO Box 47
Pope, MS 38658-0047
Phone (901) 355-2383

Other identifiers 1

IdentifierTypeStateIssuer
4440804OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • FIRST PHARMACY SERVICES OF TENNESSEE LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210521000563 TN Part B Supplier - Mass Immunization (Roster Biller Only) 7517152556 Practice locations: Mephis, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1063693067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47",
            "city": "POPE",
            "state": "MS",
            "postal_code": "386580047",
            "telephone_number": "901-355-2383",
            "fax_number": "662-893-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 ALICE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381066543",
            "telephone_number": "901-946-1375",
            "fax_number": "901-946-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST PHARMACY SERVICES OF TENNESSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "901-946-1375",
        "authorized_official_credential": "D PH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "00004454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4440804",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRST PHARMACY SERVICES OF TENNESSEE LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.

Verify at the official NPI Registry.