NPIMap

Organization Active NPI

William Carlyle Johnson

Doing business as Riverside Medical Pharmacy

  • Oxygen Equipment & Supplies (DME)
  • Shelbyville, TN
National Provider Identifier
1447458542
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
WILLIAM CARLYLE JOHNSON
Doing business as
Riverside Medical Pharmacy
Practice address
710 Madison St
Suite C
Shelbyville, TN 37160-3519
Phone
(931) 536-1414
Fax
(931) 684-6999
NPI assigned
Jul 10, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
William Carlyle Johnson, D.PH.NPI 1215060793
Title
Owner Pharmacist
Phone
(931) 536-1414

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

710 Madison St
Suite C
Shelbyville, TN 37160-3519

Mailing address

710 Madison St
Suite C
Shelbyville, TN 37160-3519
Phone (931) 536-1414

Other identifiers 1

IdentifierTypeStateIssuer
1455165MedicaidTN

Other names 1

  • RIVERSIDE MEDICAL PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

710 Madison St
Ste C
Shelbyville, TN 37160
Phone (931) 536-1414

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": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1447458542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MADISON ST",
            "address_2": "SUITE C",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603519",
            "telephone_number": "931-536-1414",
            "fax_number": "931-684-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MADISON ST",
            "address_2": "SUITE C",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603519",
            "telephone_number": "931-536-1414",
            "fax_number": "931-684-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM CARLYLE JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CARLYLE",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "931-536-1414",
        "authorized_official_credential": "D.PH."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455165",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERSIDE MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.