STATE OF TENNESSEE STATE F & A PAYROLL (NPI# 1104869486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104869486 |
| Entity Type | Organization |
| Organization Name | STATE OF TENNESSEE STATE F & A PAYROLL |
| Other Organization Name | MOCCASIN BEND MENTAL HEALTH INST |
| Practice Address |
100 Moccasin Bend Rd Chattanooga TN 37405-4415 |
| Practice Telephone | 4237853321 |
| Practice Fax Number | 4237853454 |
| Mailing Telephone | 4237853321 |
| Mailing Fax Number | 4237853454 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2014-10-14 |
| Authorized Official Name | JASON CARTER (CHIEF OF PHARMACY) |
| Authorized Official Telephone | 6155326736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
L2(16)M21051098 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2088533 | 01 |
| Other Name | Type Code |
|---|---|
| MOCCASIN BEND MENTAL HEALTH INST | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457435893 | State of Tennessee State F & A Payroll | Psychiatric Hospital | 951 Court Ave, Memphis, TN 38103-2813 | 2006-10-24 |
| 1699796664 | State of Tennessee State F & A Payroll | Pharmacy | 710 Hart Ln, Nashville, TN 37216-2649 | 2006-07-22 |
| 1295777019 | State of Tennessee State F & A Payroll | Pharmacy | 5908 Lyons View Pike, Knoxville, TN 37919-7520 | 2006-06-13 |
| Street Address |
100 MOCCASIN BEND RD |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37405-4415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306818265 | State of Tennessee F&a Payroll | Psychiatric Unit | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2006-02-06 |
| 1235648437 | Rachel Ann Looney | Family Medicine | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2017-09-20 |
| 1558805424 | Madeleine Mercedes Ramirez | Nurse Practitioner | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2016-12-13 |
| 1568822930 | April Deanne Horton | Clinical Nurse Specialist | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2016-02-29 |
| 1437425949 | Audrey Hime | Psychiatry & Neurology | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2012-03-29 |
| 1346545159 | Melisa Couey | Psychiatry & Neurology | 100 Moccasin Bend Rd, Chattanooga, TN 37405 | 2011-01-26 |
| 1598906109 | Emelito R. Pinga | Family Medicine | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2009-03-11 |
| 1336320886 | Minnie Bernice Troupe | Clinical Nurse Specialist | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2007-11-26 |
| 1003032004 | Timothy Donald Woodward | Pharmacist | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2007-04-18 |
| 1912123910 | Jeffrey A Flanagan | Pharmacist | 100 Moccasin Bend Rd, Chattanooga, TN 37405-4415 | 2007-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649878059 | Natasha A Anderson | Social Worker | 711 Signal Mountain Rd., 241, Chattanooga, TN 37405 | 2020-10-16 |
| 1093340333 | Dave Aitken | Chiropractor | 110 Woodland Ave., Chattanooga, TN 37405 | 2020-03-06 |
| 1285127944 | Kristin Stark | Marriage & Family Therapist | 1307 Hixson Pike, Chattanooga, TN 37405 | 2018-06-07 |
| 1205339033 | Ignite Chiropractic, LLC | Chiropractor | 200 Manufacturers Rd, Ste 210, Chattanooga, TN 37405 | 2018-03-18 |
| 1710486881 | Alexis Beasley Gaylor | Specialist/Technologist | 1185 Mountian Creek Road, Apt 405, Chattanooga, TN 37405 | 2018-02-05 |
| 1821538562 | Red Bank Operations, LLC | Skilled Nursing Facility | 1020 Runyan Drive, Chattanooga, TN 37405 | 2017-02-28 |
| 1619414166 | Jacquelyn Ann Casey | Social Worker | 201 Frazier Avenue, Suite E, Chattanooga, TN 37405 | 2017-01-23 |
| 1154876746 | Joan Stewart Mickles | Counselor | 9 Fairhills Drive, Chattanooga, TN 37405 | 2016-08-24 |
| 1750741088 | Weena Rivera | Counselor | 936 Mountain Creek Rd E-59, Apt E59, Chattanooga, TN 37405 | 2016-02-29 |
| 1063814515 | Mcallister Personal Care Consultants | Home Health | 419 N. Market Street, Chattanooga, TN 37405 | 2014-09-16 |
| Find all providers in zip 37405 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679546782 | Access Drugs, LLC | Pharmacy | 4062 Hixson Pike, Chattanooga, TN 37415-3110 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199432 | Boones Creek Pharmacy, Inc. | Pharmacy | 4729 N Roan St Ste 2, Johnson City, TN 37615-3886 | 2020-09-18 |
| 1164032546 | Polaris Pharmacy Services of Tennessee, LLC | Pharmacy | 7005 Wesbelt Drive, Nashville, TN 32709 | 2020-07-31 |
| 1386261030 | Jeffrey Allan Anderson | Pharmacy | 721 N Tennessee Ave, Etowah, TN 37331-1754 | 2020-06-29 |
| 1376171652 | Boatwright Drug Co., Inc | Pharmacy | 7899 Leroy Boatwright St, Millington, TN 38053-2137 | 2020-03-31 |
| 1245868850 | Seymour Pharmacy Inc. | Pharmacy | 10721 Chapman Hwy Ste 6, Seymour, TN 37865-4771 | 2020-03-30 |
| 1700423654 | Southland Ltc Pharmacy | Pharmacy | 482 Interstate Dr Ste L, Manchester, TN 37355-3485 | 2019-12-10 |
| 1104380930 | Fannon Drug Co. | Pharmacy | 606 E. Emory Rd, Powell, TN 37849 | 2019-01-25 |
| 1538663281 | Black Bear Pharmacy, Inc. | Pharmacy | 110 Keith St Sw Ste 1and2, Cleveland, TN 37311-5868 | 2018-03-19 |
| 1891231734 | Rams Pharmacy LLC | Pharmacy | 1210 Hazelwood Dr Ste D, Smyrna, TN 37167-3964 | 2017-01-17 |
| 1982056529 | Pharmblue Tennessee LLC | Pharmacy | 1113 Murfreesboro Rd Ste 319-b, Franklin, TN 37064-1306 | 2016-07-07 |
| Find all providers with the same taxonomy | ||||
| City | CHATTANOOGA |
| Zip Code | 37405 |
Please comment or provide details below to improve the information on STATE OF TENNESSEE STATE F & A PAYROLL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.