NPIMap

Organization Active NPI

Southeast Mental Health Center, Inc

  • Institutional Pharmacy
  • Memphis, TN
National Provider Identifier
1669535779
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
8296 Issued in TN
Legal business name
SOUTHEAST MENTAL HEALTH CENTER, INC
Practice address
135 N Pauline St
CBH - Southeast Mental Health Center Pharmacy
Memphis, TN 38105-4619
Phone
(901) 577-6167
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Owen Eugene Lawrence, MA
Title
Executive Director
Phone
(901) 369-1420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 8296 TN Primary

Addresses

Primary practice location

135 N Pauline St
CBH - Southeast Mental Health Center Pharmacy
Memphis, TN 38105-4619

Mailing address

3810 Winchester Rd
Southeast Mental Health Center
Memphis, TN 38118-6045
Phone (901) 369-1420

Other identifiers 1

IdentifierTypeStateIssuer
399596MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Southeast Mental HLTH CNTR6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669535779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 WINCHESTER RD",
            "address_2": "SOUTHEAST MENTAL HEALTH CENTER",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381186045",
            "telephone_number": "901-369-1420",
            "fax_number": "901-369-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N PAULINE ST",
            "address_2": "CBH - SOUTHEAST MENTAL HEALTH CENTER PHARMACY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054619",
            "telephone_number": "901-577-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MENTAL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-369-1420",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "TN",
            "license": "8296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399596",
            "state": "TN"
        }
    ],
    "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 Aug 22, 2020; 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.