NPIMap

Organization Active NPI

Shelby County Health Care Corporation

Doing business as Regional One Health Pharmacy S. Third St.

  • Clinic Pharmacy
  • Memphis, TN
National Provider Identifier
1316428410
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
SHELBY COUNTY HEALTH CARE CORPORATION
Doing business as
Regional One Health Pharmacy S. Third St.
Regional One Health Pharmacy South Third Street
Practice address
1977 S 3Rd St
Memphis, TN 38109-7713
Phone
(901) 515-4646
Fax
(901) 515-4649
NPI assigned
Aug 27, 2018
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SHELBY COUNTY HEALTH CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Kay Ryan, D.PH.NPI 1891009726
Title
Pharmacy Director
Phone
(901) 545-7840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1977 S 3Rd St
Memphis, TN 38109-7713

Mailing address

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7847

Other identifiers 2

IdentifierTypeStateIssuer
Q045253MedicaidTN
4451186OtherNCPDP

Other names 2

  • Regional One Health Pharmacy S. Third St. Doing business as
  • Regional One Health Pharmacy South Third Street Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20130627000415 TN Part B Supplier - Pharmacy 6608784855 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Memphis, TN; Bartlett, TN
O20190624001320 TN DME Supplier - Pharmacy 6608784855 Practice locations: Memphis, TN
O20210318002930 TN Part B Supplier - Mass Immunization (Roster Biller Only) 6608784855 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Memphis, TN; Bartlett, TN

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Regional One Health Pharmacy Third1977 S 3Rd St, Memphis, TN 38109-7713(901) 515-4646 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 1, 1999

National Provider Directory

National Provider Directory
Tax ID family
Regional Medical Center9 organizations share this tax ID, including this one
Part of
Regional Medical Center

Other organizations with this tax ID 8

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

Locations

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Regional One Health Extended Care HospitalMemphis, TN, CCN 442017 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1316428410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-7847",
            "fax_number": "901-545-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 S 3RD ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381097713",
            "telephone_number": "901-515-4646",
            "fax_number": "901-515-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY COUNTY HEALTH CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHELBY COUNTY HEALTH CARE CORPORATION",
        "enumeration_date": "2018-08-27",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "901-545-7840",
        "authorized_official_credential": "D.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q045253",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4451186",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional One Health Pharmacy S. Third St.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Regional One Health Pharmacy South Third Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.