Provider Demographics
NPI:1285845750
Name:MEMPHIS AND SHELBY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MEMPHIS AND SHELBY COUNTY HEALTH DEPARTMENT
Other - Org Name:MSCHD PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:ACTING HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-544-7600
Mailing Address - Street 1:814 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-5041
Mailing Address - Country:US
Mailing Address - Phone:901-544-7597
Mailing Address - Fax:901-544-7602
Practice Address - Street 1:814 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-5041
Practice Address - Country:US
Practice Address - Phone:901-544-7597
Practice Address - Fax:901-544-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000001573336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000000157OtherPHARMACY ID NUMBER