Provider Demographics
NPI:1376607135
Name:MEMORIAL HEALTH CARE SYSTEM INC
Entity Type:Organization
Organization Name:MEMORIAL HEALTH CARE SYSTEM INC
Other - Org Name:MEMORIAL HOSPITAL OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-495-7878
Mailing Address - Street 1:2525 DESALES AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1161
Mailing Address - Country:US
Mailing Address - Phone:423-495-2525
Mailing Address - Fax:423-495-6312
Practice Address - Street 1:2525 DESALES AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1161
Practice Address - Country:US
Practice Address - Phone:423-495-8981
Practice Address - Fax:423-495-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000031513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy