NPIMap

Organization Active NPI

Medical Center Pharmacy Inc

  • Health Service Clinic/Center
  • Cleveland, TN
National Provider Identifier
1497116529
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MEDICAL CENTER PHARMACY INC
Practice address
2401 N Ocoee St
Suite 301
Cleveland, TN 37311-3853
Phone
(423) 472-5548
Fax
(423) 472-5548
NPI assigned
Mar 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Authorized official

Name
Joe Shannon Moore
Title
Owner
Phone
(423) 472-5548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

2401 N Ocoee St
Suite 301
Cleveland, TN 37311-3853

Mailing address

PO Box 3240
Cleveland, TN 37320-3240
Phone (423) 472-5548

Other identifiers 2

IdentifierTypeStateIssuer
3524217MedicaidTN
0128150001OtherMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Pharm THHC3 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.

Locations

2401 N Ocoee St
Ste 301
Cleveland, TN 37311
Phone (423) 472-5548

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1497116529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3240",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373203240",
            "telephone_number": "423-472-5548",
            "fax_number": "423-472-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 N OCOEE ST",
            "address_2": "SUITE 301",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113853",
            "telephone_number": "423-472-5548",
            "fax_number": "423-472-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-472-5548"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3524217",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0128150001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.