NPIMap

Organization Active NPI

Professional Care Services of West TN Inc

  • Long Term Care Pharmacy
  • Covington, TN
National Provider Identifier
1720145717
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PROFESSIONAL CARE SERVICES OF WEST TN INC
Practice address
1997 Highway 51 S
Covington, TN 38019-3630
Phone
(901) 475-3586
Fax
(901) 313-1153
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Tom Griffin
Title
Controller
Phone
(901) 622-1688

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 189 TN
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1997 Highway 51 S
Covington, TN 38019-3630

Mailing address

1997 Highway 51 S
Covington, TN 38019-3630
Phone (901) 475-3586

Other identifiers 2

IdentifierTypeStateIssuer
3722813MedicaidTN
2088675OtherPK

Other names 1

  • PCS COVINGTON Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Care Services of West TN Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1720145717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1997 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193630",
            "telephone_number": "901-475-3586",
            "fax_number": "901-313-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1997 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193630",
            "telephone_number": "901-475-3586",
            "fax_number": "901-313-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CARE SERVICES OF WEST TN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "901-622-1688"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "189",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3722813",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2088675",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCS COVINGTON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PCS COVINGTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.