Advantage Pharmacy LLC

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

5094 Issued in TN

Legal business name

ADVANTAGE PHARMACY LLC

Practice address

2175 Business Center Dr Ste 6
Memphis, TN 38134-5628

Phone

(901) 881-9770

Fax

(866) 488-7820

NPI assigned

Nov 27, 2012

Organization subpart

No

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

Authorized official

Name

Craig Gilmore

Title

President

Phone

(800) 662-9220

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Advantage Pharmacy LLC Doing business as

Locations

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1134463425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 BUSINESS CENTER DR",
            "address_2": "STE. 6",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381345628",
            "telephone_number": "901-881-9770",
            "fax_number": "866-488-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 BUSINESS CENTER DR STE 6",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381345628",
            "telephone_number": "901-881-9770",
            "fax_number": "866-488-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-662-9220"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "TN",
            "license": "5094",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4445498",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.