NPIMap

Organization Active NPI

Christ Community Health Services Inc

Doing business as CHRIST COMM HEALTH SVS- Broad Ave Pharmacy

  • Community/Retail Pharmacy
  • Memphis, TN
National Provider Identifier
1891837290
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
4203 Issued in TN
Legal business name
CHRIST COMMUNITY HEALTH SERVICES INC
Doing business as
CHRIST COMM HEALTH SVS- Broad Ave Pharmacy
Practice address
2861 Broad Ave
Memphis, TN 38112-2903
Phone
(901) 260-8475
Fax
(901) 260-8476
NPI assigned
Feb 13, 2007
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
Tracy McDaniel
Title
Ceo
Phone
(901) 842-3160

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 4203 TN Primary

Addresses

Primary practice location

2861 Broad Ave
Memphis, TN 38112-2903

Mailing address

2670 Union Avenue Ext Ste 1000
Memphis, TN 38112-4416
Phone (901) 842-3160

Other identifiers 2

IdentifierTypeStateIssuer
3707256MedicaidTN
2094727OtherPK

Other names 1

  • CHRIST COMM HEALTH SVS- Broad Ave Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Christ Community Health Services Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1891837290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 UNION AVENUE EXT STE 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381124416",
            "telephone_number": "901-842-3160",
            "fax_number": "901-260-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 BROAD AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381122903",
            "telephone_number": "901-260-8475",
            "fax_number": "901-260-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIST COMMUNITY HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-842-3160"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "4203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3707256",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2094727",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRIST COMM HEALTH SVS- Broad Ave Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRIST COMM HEALTH SVS- Broad Ave 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 Dec 6, 2024; 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.