SOUTHMED LLC NPI 1023146941

Pharmacy (Long Term Care Pharmacy) in Memphis, TN

About SOUTHMED LLC

Southmed Llc is a provider in Memphis, TN. The NPI number assigned to this provider is 1023146941. The practitioner's primary taxonomy code is Pharmacy (3336L0003X). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Medicap Pharmacy Ltc.

NPI

1023146941

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameSOUTHMED LLC
Provider Location Address2435 WHITTEN RD STE 102 MEMPHIS, TN 38133 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address2435 WHITTEN RD STE 102 MEMPHIS, TN 38133 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameMEDICAP PHARMACY LTC Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date03-01-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date04-22-2008 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code3336L0003X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationPharmacy
TypeSuppliers
SpecializationLong Term Care Pharmacy
License No.4367
License StateTN
Taxonomy DescriptionA 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.

Business Address

SOUTHMED LLC
2435 WHITTEN RD
STE 102
MEMPHIS, TN
ZIP 38133
Phone: (901) 377-2225
Fax: (901) 377-7992

Get Directions

Mailing Address

SOUTHMED LLC
2435 WHITTEN RD
STE 102
MEMPHIS, TN
ZIP 38133
Phone:

Authorized Official

Authorized Official Name LISA TIMBERLAND PHRM D Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleOWNER PHARMACIST
Authorized Official Phone(901) 377-2225

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
5431850003MEDICARE NSC (07)
4440094OTHER (01)

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1407928203SOUTHMED LLC
Organization
Pharmacy (Community/Retail Pharmacy)2435 WHITTEN RD SUITE 101
MEMPHIS, TN 38133
(901) 377-2225
Previous NPI
1023146925
Next NPI
1023146958