Active NPI
Omnicare Pharmacy of Tennessee, LLC
- Long Term Care Pharmacy
- Cleveland, TN
National Provider Identifier
1083644090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- OMNICARE PHARMACY OF TENNESSEE, LLC
- Doing business as
- Omnicare of Tennessee #48345
- Practice address
- 145 Industrial Way SW
Cleveland, TN 37311-7114 - Phone
- (423) 339-2999
- NPI assigned
- Jul 4, 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
- Susan Colbert
- Title
- Sr Director, Payer Relations
- Phone
- (401) 770-2751
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
145 Industrial Way SW
Cleveland, TN 37311-7114
Mailing address
1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Other names 1
- Omnicare of Tennessee #48345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930091582 | TN | DME Supplier - Pharmacy | 3476674722 | Practice locations: Cleveland, TN |
| O20231025003637 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 3476674722 | Practice locations: Cleveland, TN |
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
-
- Long Term Care Pharmacy
- San Antonio, TX
- NPI 1174559694
Member Of
Member organizations 3
Organizations listed as members of this organization in the National Provider Directory.
-
- Long Term Care Pharmacy
- San Antonio, TX
- NPI 1174559694
Member Of
Locations
145 Industrial Way SW
Cleveland, TN 37311
Phone (423) 339-2999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1552348800000",
"number": "1083644090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CVS DR",
"address_2": "BOX 1075",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028956146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 INDUSTRIAL WAY SW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373117114",
"telephone_number": "423-339-2999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OMNICARE PHARMACY OF TENNESSEE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-04",
"last_updated": "2019-03-12",
"status": "A",
"authorized_official_last_name": "COLBERT",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "SR DIRECTOR, PAYER RELATIONS",
"authorized_official_telephone_number": "401-770-2751"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Omnicare of Tennessee #48345",
"code": "3",
"type": "Doing Business As"
}
]
}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 Mar 12, 2019; 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.