NPIMap

Organization Active NPI

Alliance Healthcare Services

Doing business as Alliance Healthcare System Whitney Pharmacy

  • Clinic Pharmacy
  • Memphis, TN
National Provider Identifier
1912312828
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
0000005383 Issued in TN
Legal business name
ALLIANCE HEALTHCARE SERVICES
Doing business as
Alliance Healthcare System Whitney Pharmacy
Whitney Pharmacy
Practice address
2150 Whitney Ave
Memphis, TN 38127-6662
Phone
(901) 354-7621
Fax
(901) 354-7622
NPI assigned
Jun 30, 2014
Last updated
Apr 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Marcus Lyles
Title
Pharmacy Manager
Phone
(901) 354-7621

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X 0000005383 TN Primary

Addresses

Primary practice location

2150 Whitney Ave
Memphis, TN 38127-6662

Mailing address

2150 Whitney Ave
Memphis, TN 38127-6662
Phone (901) 354-7621

Other identifiers 1

IdentifierTypeStateIssuer
2146803OtherPK

Other names 2

  • ALLIANCE HEALTHCARE SYSTEM WHITNEY PHARMACY Doing business as
  • Whitney Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230727000783 TN Part B Supplier - Pharmacy 4082766621 Practice locations: Memphis, TN

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Southeast Mental HLTH Ctr6 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.

Locations

1200 Peabody Ave
Memphis, TN 38104
Phone (901) 272-0003

1210 Peabody Ave
Memphis, TN 38104
Phone (901) 272-0003

2100 Whitney Ave
Memphis, TN 38127
Phone (901) 353-5440

2579 Douglass Ave
Memphis, TN 38114
Phone (901) 369-1418

951 Court Ave
Memphis, TN 38103
Phone (901) 577-1800

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 91

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 91

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1912312828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276662",
            "telephone_number": "901-354-7621",
            "fax_number": "901-354-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276662",
            "telephone_number": "901-354-7621",
            "fax_number": "901-354-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "901-354-7621"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "TN",
            "license": "0000005383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146803",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALLIANCE HEALTHCARE SYSTEM WHITNEY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Whitney 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 Apr 12, 2021; 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.