NPIMap

Organization Active NPI

Darsalud Community Center Inc

Doing business as Lifedoc Pharmacy

  • Community/Retail Pharmacy
  • Memphis, TN
National Provider Identifier
1841158375
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DARSALUD COMMUNITY CENTER INC
Doing business as
Lifedoc Pharmacy
Practice address
6625 Lenox Park Dr Ste 100
Memphis, TN 38115-8201
Phone
(901) 683-0024
Fax
(901) 683-0086
NPI assigned
Jan 13, 2026
Last updated
Jul 14, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
DARSALUD COMMUNITY CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Andrea Ivory Fuller, CPC
Title
Billing and Credentialing Manager
Phone
(901) 922-5951

Specialties & licenses 1

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

Addresses

Primary practice location

6625 Lenox Park Dr Ste 100
Memphis, TN 38115-8201

Mailing address

6625 Lenox Park Dr Ste 202
Memphis, TN 38115-8200
Phone (901) 683-0024

Other names 1

  • LIFEDOC PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260611000266 TN Part B Supplier - Pharmacy 1759706567 Practice locations: Memphis, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Darsalud Community Center Inc

Locations

6625 Lenox Park Dr
Ste 100
Memphis, TN 38115

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1841158375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LENOX PARK DR STE 202",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381158200",
            "telephone_number": "901-683-0024",
            "fax_number": "901-683-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LENOX PARK DR STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381158201",
            "telephone_number": "901-683-0024",
            "fax_number": "901-683-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARSALUD COMMUNITY CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DARSALUD COMMUNITY CENTER INC",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "IVORY FULLER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-922-5951",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFEDOC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 14, 2026; 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.