NPIMap

Organization Active NPI

Professional Care Services of West TN Inc

Doing business as Susan E Ingram Center

  • Long Term Care Pharmacy
  • Millington, TN
National Provider Identifier
1144386855
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PROFESSIONAL CARE SERVICES OF WEST TN INC
Doing business as
Susan E Ingram Center
Practice address
5281 Navy Rd
Millington, TN 38053-2535
Phone
(901) 873-0305
Fax
(901) 873-0306
NPI assigned
Dec 28, 2006
Last updated
Jul 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Mr. Tom Griffin
Title
Controller
Phone
(901) 622-1688

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 3856 TN
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

5281 Navy Rd
Millington, TN 38053-2535

Mailing address

1997 Hwy 51 S
Covington, TN 38019-3630
Phone (901) 476-8967

Other identifiers 1

IdentifierTypeStateIssuer
4436350OtherNCPDP

Other names 1

  • Susan E Ingram Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Care Services of West TN Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1144386855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1997 HWY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193630",
            "telephone_number": "901-476-8967",
            "fax_number": "901-313-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5281 NAVY RD",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380532535",
            "telephone_number": "901-873-0305",
            "fax_number": "901-873-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CARE SERVICES OF WEST TN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "901-622-1688",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "3856",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4436350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan E Ingram Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Susan E Ingram Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.