NPIMap

Organization Active NPI

Neovance Specialty Pharmacy LLC

  • Pharmacy
  • Memphis, TN
National Provider Identifier
1194647206
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NEOVANCE SPECIALTY PHARMACY LLC
Practice address
5025 Tuggle Rd # 100
Memphis, TN 38118-7514
Phone
(866) 842-2147
Fax
(866) 842-2147
NPI assigned
Jul 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Nancy Costlow, COSTLOW
Title
VP, Clinical and Pharmacy Operation
Phone
(689) 257-3345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

5025 Tuggle Rd # 100
Memphis, TN 38118-7514

Mailing address

5025 Tuggle Rd # 100
Memphis, TN 38118-7514
Phone (866) 842-2147

National Provider Directory

National Provider Directory
Tax ID family
Neovance Specialty Pharmacy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1194647206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5025 TUGGLE RD # 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381187514",
            "telephone_number": "866-842-2147",
            "fax_number": "866-842-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 TUGGLE RD # 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381187514",
            "telephone_number": "866-842-2147",
            "fax_number": "866-842-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOVANCE SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "COSTLOW",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "VP, CLINICAL AND PHARMACY OPERATION",
        "authorized_official_telephone_number": "689-257-3345",
        "authorized_official_credential": "COSTLOW"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 29, 2026; 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.