NPIMap

Organization Active NPI

Shelby County Health Care Corporation

Doing business as Regional One Health Pharmacy Stage Post

  • Clinic Pharmacy
  • Bartlett, TN
National Provider Identifier
1679120281
Registry record updated Aug 20, 2019
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 Stage Post
T
Practice address
3111 Stage Post Dr Ste 102-104
Bartlett, TN 38133-4042
Phone
(901) 545-7847
Fax
(901) 545-7557
NPI assigned
Aug 20, 2019
Last updated
Aug 20, 2019By 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 Aug 20, 2019

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

Authorized official

Name
Mr. James Richard Wagers Jr.
Title
Sevp and Cfo
Phone
(901) 545-7676

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X NU Primary
Community/Retail Pharmacy 3336C0003X NU
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

3111 Stage Post Dr Ste 102-104
Bartlett, TN 38133-4042

Mailing address

877 Jefferson Ave
Attention: Pharmacy Admin. 2ND Floor Turner Tower
Memphis, TN 38103-2807
Phone (901) 545-7847

Other names 2

  • Regional One Health Pharmacy Stage Post Doing business as
  • T Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

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
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 on the same Medicare enrollment 4

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1679120281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "ATTENTION: PHARMACY ADMIN. 2ND FLOOR TURNER TOWER",
            "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": "3111 STAGE POST DR STE 102-104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334042",
            "telephone_number": "901-545-7847",
            "fax_number": "901-545-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY COUNTY HEALTH CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHELBY COUNTY HEALTH CARE CORPORATION",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "WAGERS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "SEVP AND CFO",
        "authorized_official_telephone_number": "901-545-7676",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional One Health Pharmacy Stage Post",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "T",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.