FORMULAB LLC (NPI# 1174834758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174834758 |
| Entity Type | Organization |
| Organization Name | FORMULAB LLC |
| Other Organization Name | COMMUNITY PHARMACY |
| Practice Address |
5821 Walden Dr Knoxville TN 37919-6334 |
| Practice Telephone | 8655880689 |
| Practice Fax Number | 8655880680 |
| Mailing Telephone | 8655880689 |
| Mailing Fax Number | 8655880680 |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2011-05-16 |
| Authorized Official Name | SCOTTY WYATT (MEMBER) |
| Authorized Official Telephone | 8655880689 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
128 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4443420 | 01 |
| Other Name | Type Code |
|---|---|
| Community Pharmacy | Doing Business As Name - Organization |
| Street Address |
5821 WALDEN DR |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37919-6334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568780658 | Scotty Wyatt | Pharmacist | 5821 Walden Dr, Knoxville, TN 37919 | 2010-05-13 |
| 1730451154 | Anne Young Thomas | Pharmacist | 5821 Walden Dr, Knoxville, TN 37919-6334 | 2012-01-31 |
| 1467773267 | Melanie Wyatt | Pharmacist | 5821 Walden Dr, Knoxville, TN 37919 | 2010-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760099188 | Edp Biotech Corporation | Clinical Medical Laboratory | 6701 Baum Dr, Suite 110, Knoxville, TN 37919 | 2020-09-29 |
| 1649836248 | Jessica Diane Moody | Counselor | 6070 Lyons View Pike, Knoxville, TN 37919 | 2019-05-20 |
| 1952802571 | Maisie Drew Buckner | Physical Therapist | 301 S Gallaher View Rd Ste 105, Knoxville, TN 37919 | 2018-02-28 |
| 1992217400 | Jay S. Desvaux, D.d.s. | Dentist | 6311 Kingston Pike #27w, Knoxville, TN 37919 | 2017-10-25 |
| 1346768975 | Marilyn Lee | Occupational Therapist | 7014 Lawford Road, Knoxville, TN 37919 | 2017-09-04 |
| 1558884254 | Jck Holdings LLC | Family Medicine | 2270 Sutherland Avenue, Knoxville, TN 37919 | 2017-07-25 |
| 1295255503 | Emily M King | Marriage & Family Therapist | 131 N. Concord St, Knoxville, TN 37919 | 2017-06-27 |
| 1487105128 | Kathleen Rachelle Matteson | Physician Assistant | 2461 University Commons Way, Knoxville, TN 37919 | 2016-10-18 |
| 1689046161 | Meagan Lynn Ogunrinde | Registered Nurse | 265 Brockview Centre Way, Suite 400, Knoxville, TN 37919 | 2015-10-23 |
| 1720467624 | Chizoba Ngesina | Emergency Medicine | Teamhealth, 265 Brookview Centre Way Suite 400, Knoxville, TN 37919 | 2015-05-26 |
| Find all providers in zip 37919 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1346706066 | Pharmacy and Surgical Supplies Inc | Pharmacy | 4120 Asheville Hwy, Knoxville, TN 37914-3505 | 2019-02-18 |
| 1518459866 | Rocky Hill Pharmacy, LLC | Pharmacy | 7660 S Northshore Dr, Knoxville, TN 37919-8003 | 2018-06-02 |
| 1689183774 | Belew Drug Choto, Inc. | Pharmacy | 1616 Choto Markets Way, Knoxville, TN 37922-5760 | 2017-09-21 |
| 1598152498 | Caremax Community Pharmacy LLC | Pharmacy | 418 S Gay St Ste 104, Knoxville, TN 37902-1134 | 2015-04-20 |
| 1952715708 | Wal-mart Stores East Lp | Pharmacy | 2501 Univ Commons Way, Knoxville, TN 37919-5584 | 2014-06-19 |
| 1861804692 | Aasc Pharmacy Services | Pharmacy | 6701 Baum Dr, Suite 140, Knoxville, TN 37919-7360 | 2014-05-28 |
| 1366785867 | Parkwest Medical Center | Pharmacy | 220 Fort Sanders West Blvd Ste 104, Knoxville, TN 37922-3373 | 2013-04-03 |
| 1477697589 | Four Way Prescription Shop | Pharmacy | 8707a Asheville Hwy, Knoxville, TN 37924-4502 | 2007-02-20 |
| 1912049503 | Mugford Pharmacy Inc. | Pharmacy | 3909 Martin Mill Pike, Knoxville, TN 37920-2456 | 2007-02-12 |
| Find all providers in KNOXVILLE | ||||
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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.