TRITENN LLC (NPI# 1194812446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194812446 |
| Entity Type | Organization |
| Organization Name | TRITENN LLC |
| Other Organization Name | GRAY PHARMACY |
| Practice Address |
208 Suncrest St Ste 1 Gray TN 37615-3494 |
| Mailing Address |
Po Box 9205 Gray TN 37615-9205 |
| Practice Telephone | 4234773847 |
| Practice Fax Number | 4234774392 |
| Mailing Telephone | 4234773847 |
| Mailing Fax Number | 4234774392 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2018-01-29 |
| Authorized Official Name | CLAYTON FORD KILGORE (PIC/OWNER) |
| Authorized Official Telephone | 4235798400 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
C001007 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 0149630001 | 05 |
| Other Name | Type Code |
|---|---|
| Gray Pharmacy | Doing Business As Name - Organization |
| Street Address |
208 SUNCREST ST STE 1 |
| City | GRAY |
| State | TN |
| Zip Code | 37615-3494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942226568 | Gray Pharmacy | Durable Medical Equipment & Medical Supplies | 208 Suncrest St, Suite 4, Gray, TN 37615-3494 | 2006-07-15 |
| 1851476154 | Amanda D Hamby | Pharmacy Technician | 208 Suncrest St, Gray, TN 37615-3494 | 2006-10-26 |
| 1841372281 | Glen E Hall | Pharmacist | 208 Suncrest St, Suite 1, Gray, TN 37615-3494 | 2006-10-19 |
| 1083796445 | Chasity L Kilgore | Pharmacy Technician | 208 Suncrest St, Suite1, Gray, TN 37615-3494 | 2006-10-19 |
| 1477635845 | Sherry Bolden | Pharmacy Technician | 208 Suncrest St, Suite1, Gray, TN 37615-3494 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| 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] |
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|---|---|---|---|---|
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| 1598107393 | Ingles Markets Inc | Pharmacy | 261 W Clinton St, Gray, GA 31032-6123 | 2013-07-22 |
| 1023182490 | Mj Pharmacy Services Inc | Pharmacy | 236 W Clinton St, Gray, GA 31032 | 2006-11-20 |
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| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
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| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| 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.