SHELBY COUNTY HEALTH CARE CORPORATION (NPI# 1629542493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629542493 |
| Entity Type | Organization |
| Organization Name | SHELBY COUNTY HEALTH CARE CORPORATION |
| Other Organization Name | REGIONAL ONE HEALTH PHARMACY PCS WALNUT GROVE |
| Practice Address |
3109 Walnut Grove Rd Memphis TN 38111-3509 |
| Mailing Address |
877 Jefferson Ave Attention: Pharmacy Administration Memphis TN 38103-2807 |
| Practice Telephone | 9015153434 |
| Practice Fax Number | 9015153439 |
| Mailing Telephone | 9015457847 |
| Mailing Fax Number | 9015457552 |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2020-04-23 |
| Authorized Official Name | JAMES RICHARD WAGERS (EVP AND CFO) |
| Authorized Official Telephone | 9015457676 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 4451578 | 01 | |
| TN | Q047999 | 05 | |
| DEA | FR8268143 | 01 |
| Other Name | Type Code |
|---|---|
| Regional One Health Pharmacy PCS Walnut Grove | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679120281 | Shelby County Health Care Corporation | Pharmacy | 3111 Stage Post Dr Ste 102-104, Bartlett, TN 38133-4042 | 2019-08-20 |
| 1053393231 | Shelby County Health Care Corporation | Rehabilitation Hospital | 890 Madison Avenue, Memphis, TN 38103 | 2005-11-15 |
| 1932725611 | Shelby County Health Care Corporation | Pharmacy | 1588 Union Ave, Memphis, TN 38104-3729 | 2020-06-18 |
| 1316428410 | Shelby County Health Care Corporation | Pharmacy | 1977 S 3rd St, Memphis, TN 38109-7713 | 2018-08-27 |
| 1245603620 | Shelby County Health Care Corporation | Pharmacy | 6555 Quince Rd, Attention: Pharmacy, Memphis, TN 38119-8202 | 2015-11-05 |
| 1013313865 | Shelby County Health Care Corporation | Skilled Nursing Facility | 877 Jefferson Ave, 3rd Floor, Adams Pavilion, Memphis, TN 38103-2807 | 2014-11-06 |
| 1710959614 | Shelby County Health Care Corporation | Pharmacy | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2006-02-03 |
| 1780685750 | Shelby County Health Care Corporation | Clinic/Center | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2005-08-02 |
| Street Address |
3109 WALNUT GROVE RD |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38111-3509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841234879 | Patricia W Bader | Nurse Practitioner | 3109 Walnut Grove Rd, Memphis, TN 38111-3509 | 2006-06-16 |
| 1356990980 | Jade Lee Wilkie | Nurse Practitioner | 3109 Walnut Grove Rd, Memphis, TN 38111-3509 | 2019-09-06 |
| 1861965667 | Nastassia Smith | Nurse Practitioner | 3109 Walnut Grove Rd, Memphis, TN 38111-3509 | 2019-01-04 |
| 1003381229 | Cinda Cox Berryhill | Nurse Practitioner | 3109 Walnut Grove Rd, Memphis, TN 38111-3509 | 2018-10-04 |
| 1255797627 | Lauren Cunningham | Family Medicine | 3109 Walnut Grove Rd, Memphis, TN 38111-3509 | 2016-01-14 |
| 1750506861 | Bradford Daniel Pendley | Internal Medicine | 3109 Walnut Grove Rd, Memphis, TN 38111-3509 | 2007-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982168035 | Meghan Weakley Pace | Occupational Therapist | 177 North Highlanld Ave, Memphis, TN 38111 | 2019-01-23 |
| 1386130466 | Christopher Cory Wilbanks | Nurse Practitioner | 3445 Poplar Ave Ste 18, Memphis, TN 38111 | 2018-07-02 |
| 1124523287 | Hands of Health and Rehab | Clinic/Center | 80 N. Tillman St. Ste. 104, Memphis, TN 38111 | 2018-03-29 |
| 1659889889 | Jarod Lenahan | Specialist/Technologist | 1115 East Getwell Loop St, Memphis, TN 38111 | 2018-01-22 |
| 1831645100 | Bobby Winbush | Residential Treatment Facility, Emotionally Disturbed Children | 1167 Parkland Rd, Memphis, TN 38111 | 2016-08-28 |
| 1356797427 | Shilo Satran | Counselor | 208 Waynoka Lane, Memphis, TN 38111 | 2016-05-09 |
| 1346580552 | Bianca Branch | Psychologist | 4166 W Bufford Ellington Dr, Memphis, TN 38111 | 2013-02-25 |
| 1043563935 | Midsouth Vision Center | Optometrist | 3314 Poplar Ave Ste#1, Memphis, TN 38111 | 2012-10-17 |
| 1235407750 | Demetria Nicole Rogers | Pharmacist | 3515 Park Avenue, Memphis, TN 38111 | 2011-12-12 |
| 1326335647 | Jason Thomas Sasser | Nurse Practitioner | 3444 Plaza Ave., The Little Clinic, Memphis, TN 38111 | 2011-07-07 |
| Find all providers in zip 38111 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1932725611 | Shelby County Health Care Corporation | Pharmacy | 1588 Union Ave, Memphis, TN 38104-3729 | 2020-06-18 |
| 1972952976 | Dar Salud Care Pllc | Pharmacy | 1068 Cresthaven Rd, Suite 300, Memphis, TN 38119-0800 | 2016-06-09 |
| 1184801722 | Christ Community Health Services, Inc | Pharmacy | 3362 S 3rd St, Memphis, TN 38109-2944 | 2008-01-25 |
| 1285845750 | Memphis and Shelby County Health Department | Pharmacy | 814 Jefferson Ave, Memphis, TN 38105-5041 | 2007-05-25 |
| 1063575165 | Southeast Mental Health Center, Inc | Pharmacy | 2579 Douglass Ave, Southeast Mental Health Center, Memphis, TN 38114-2532 | 2006-12-19 |
| 1164433710 | St Jude Children's Research Hospital, Inc. | Pharmacy | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2006-08-10 |
| 1033112230 | St Jude Childrens Research Hospital Inc | Pharmacy | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574332 | Rutherford County Primary Care | Pharmacy | 1701 N Main St Ste E, Shelbyville, TN 37160-2301 | 2020-10-06 |
| 1932764941 | Take Charge Nutrition, LLC | Pharmacy | 1690 25th St Nw Ste D, Cleveland, TN 37311-3613 | 2019-05-06 |
| 1922319383 | Advance Pharmacy Services Pllc | Pharmacy | 317 N Parkway Ste 400, Jackson, TN 38305-2713 | 2010-06-30 |
| 1902961113 | C Michael Jones Mdpc | Pharmacy | 7710 Wolf River Cir, Germantown, TN 38138-1734 | 2006-12-27 |
| 1194829150 | Clinic Pharmacy Inc | Pharmacy | 1 Hermitage Ave, Nashville, TN 37210-2109 | 2006-09-12 |
| 1437790375 | Nashville Pharmacy Services LLC | Pharmacy | 1925 Ailor Ave, Knoxville, TN 37921-5804 | 2019-10-02 |
| 1972015121 | Nashville Pharmacy Services LLC | Pharmacy | 615 N State of Franklin Rd, Johnson City, TN 37604-8209 | 2017-10-27 |
| 1154780716 | East Tennessee State University | Pharmacy | 2151 Century Ln, Johnson City, TN 37604-4469 | 2016-02-11 |
| 1871966499 | Hcchc Pharmacy | Pharmacy | 629 Nuckolls Rd, Suite A, Bolivar, TN 38008-1599 | 2015-11-04 |
| 1932352283 | Vanderbilt University Medical Center | Pharmacy | 719 Thompson Ln, Suite 24130, Nashville, TN 37204-3609 | 2008-10-30 |
| Find all providers with the same taxonomy | ||||
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| 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.