NPIMap

Organization Active NPI

State of Tennessee State F & a Payroll

  • Long Term Care Pharmacy
  • Chattanooga, TN
National Provider Identifier
1104869486
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
L2(16)M21051098 Issued in TN
Legal business name
STATE OF TENNESSEE STATE F & A PAYROLL
Practice address
100 Moccasin Bend Rd
Chattanooga, TN 37405-4415
Phone
(423) 785-3321
Fax
(423) 785-3454
NPI assigned
Jun 14, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jason Carter
Title
Chief of Pharmacy
Phone
(615) 532-6736

National Provider Directory

National Provider Directory
Tax ID family
Trousdale County Health202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X L2(16)M21051098 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

100 Moccasin Bend Rd
Chattanooga, TN 37405-4415

Mailing address

100 Moccasin Bend Rd
Chattanooga, TN 37405-4415
Phone (423) 785-3321

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
2088533OtherPK

Other names 1

NPPES NPI Registry
  • MOCCASIN BEND MENTAL HEALTH INST Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 14, 2014.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1104869486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOCCASIN BEND RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054415",
            "telephone_number": "423-785-3321",
            "fax_number": "423-785-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MOCCASIN BEND RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054415",
            "telephone_number": "423-785-3321",
            "fax_number": "423-785-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE STATE F & A PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF OF PHARMACY",
        "authorized_official_telephone_number": "615-532-6736"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "L2(16)M21051098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2088533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOCCASIN BEND MENTAL HEALTH INST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.