MEDICAL MALL PHARMACY INC


Address: 130 W Ravine Rd, Kingsport, TN 37660-3837
Phone: 4232246860

MEDICAL MALL PHARMACY INC (NPI# 1275536997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275536997
Entity Type Organization
Organization Name MEDICAL MALL PHARMACY INC
Other Organization Name WELLMONT OUTPATIENT PHARMACY
Practice Address 130 W Ravine Rd
Kingsport
TN 37660-3837
Practice Telephone 4232246860
Practice Fax Number 4232245654
Mailing Telephone 4232246860
Mailing Fax Number 4232245654
Enumeration Date 2005-05-27
Last Update Date 2009-12-03
Authorized Official Name KRISTINE HAGEE (PHARMACY SYSTEMS ANALYST)
Authorized Official Telephone 4232308432
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
C3413 TN Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
TN 3130747 05
NCPDP PROVIDER IDENTIFICATION NUMBER 4433378 01
VA 8517916 05

Other Provider/Organization Names

Other Name Type Code
Wellmont Outpatient Pharmacy Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1598768699 Medical Mall Pharmacy Inc Pharmacy 1 Medical Park Blvd, Suite 106-e, Bristol, TN 37620-7430 2005-05-23
1316191349 Medical Mall Pharmacy Inc Pharmacy 105 W Stone Dr, Suite 1-b, Kingsport, TN 37660-3256 2008-11-04

Office Location

Street Address 130 W RAVINE RD
City KINGSPORT
State TN
Zip Code 37660-3837

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598364903 Kevin White Physician Assistant 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-10-19
1093328460 Corbin Noah Turbyfill Registered Nurse 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-08-26
1871106153 Garon Rick Compton Registered Nurse 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-08-26
1780297010 Caleb Rumley Registered Nurse 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-08-26
1992314587 Ryan Earl Farmer Emergency Medicine 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-07-29
1043837933 Verna Theola Barton Pharmacist 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-06-26
1962028043 Kendra Lauren O'quinn Nurse Practitioner 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-06-24
1427673672 Brooke Stayer Pharmacist 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-06-13
1982228847 Jordan Bacon Physician Assistant 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-06-05
1851914600 Amy F Kite Pathology 130 W Ravine Rd, Kingsport, TN 37660-3837 2020-05-27
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750909891 Nancy Gober Pharmacist Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 2020-07-06
1700437621 Tammy Denise Leblanc Technician 125 Lancer Rd, Kingsport, TN 37660 2019-09-23
1831743392 Independent Physical Therapy Occupational Therapist 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 2019-08-01
1871095315 Macie Anderson Nurse Practitioner 411 Clay St, Kingsport, TN 37660 2018-03-01
1053813527 Pulitzer Orthodontics, LLC Dentist 1200 Pulitzer Place, Kingsport, TN 37660 2018-03-01
1174038749 Sbh-kingsport Psychiatric Hospital 1025 Executive Park Blvd, Kingsport, TN 37660 2017-12-05
1548771447 Sara B Ball Registered Nurse 111 W Stone Dr Ste 240, Kingsport, TN 37660 2017-10-18
1821525361 Ashley Brook Weems Nurse Practitioner Six Sheridan Square Suite 100, Kingsport, TN 37660 2017-05-15
1639625643 Stephanie H Garris Nurse Practitioner 117 W Sevier Ave Ste 120, Kingsport, TN 37660 2016-08-30
1073965679 Teresa Anne Starke Physician Assistant 8 Sheridan Square, Suite 110, Kingsport, TN 37660 2016-07-07
Find all providers in zip 37660

Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619003399 Colonial Heights Pharmacy, Inc. Pharmacy 4221 Ft. Henry Drive, Kingsport, TN 37663 2007-02-26
1043313745 Tennessee Cvs Pharmacy LLC Pharmacy 128 W Stone Dr, Kingsport, TN 37660-3221 2006-09-07
1700989159 Tennessee Cvs Pharmacy LLC Pharmacy 4400 W Stone Dr, Kingsport, TN 37660-1051 2006-09-07
1871696583 Tennessee Cvs Pharmacy LLC Pharmacy 4106 Fort Henry Dr, Kingsport, TN 37663-2226 2006-09-07
1861403446 Wilson Pharmacy Inc Pharmacy 1657 E Stone Dr, Ste A, Kingsport, TN 37660-4669 2006-08-10
1245247261 Walgreen Co Pharmacy 4500 W Stone Dr, Kingsport, TN 37660-1049 2006-08-02
1508871542 Walgreen Co Pharmacy 3900 Fort Henry Dr, Kingsport, TN 37663-2026 2006-07-29
1992326664 Jj Beans At P&s LLC Pharmacy 613 Watauga St, Kingsport, TN 37660-4429 2020-05-04
1902320989 K & M Pharmacy PC Pharmacy 4221 Fort Henry Dr, Kingsport, TN 37663-2227 2017-08-01
1407274707 Ingles Markets Inc Pharmacy 4335 Fort Henry Dr, Kingsport, TN 37664 2014-04-03
Find all providers in KINGSPORT

Competitor

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City KINGSPORT
Zip Code 37660

Improve Information

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Dataset Information

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.

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