MAYNARDVILLE PHARMACY INC (NPI# 1396766366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396766366 |
| Entity Type | Organization |
| Organization Name | MAYNARDVILLE PHARMACY INC |
| Other Organization Name | OKIE'S PHARMACY |
| Practice Address |
4221 Maynardville Hwy Maynardville TN 37807-3555 |
| Practice Telephone | 8659929455 |
| Practice Fax Number | 8659927979 |
| Mailing Telephone | 8659929455 |
| Mailing Fax Number | 8659927979 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-04-13 |
| Authorized Official Name | RAJENDRAPRASAD VENIGALLA (SECRETARY) |
| Authorized Official Telephone | 3475288893 |
| 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 |
3435 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q033563 | 05 | |
| PK | 2123620 | 01 |
| Other Name | Type Code |
|---|---|
| Okie's Pharmacy | Doing Business As Name - Organization |
| Street Address |
4221 MAYNARDVILLE HWY |
| City | MAYNARDVILLE |
| State | TN |
| Zip Code | 37807-3555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417254723 | Michelle Leach | Pharmacist | 4221 Maynardville Hwy, Maynardville, TN 37807-3555 | 2011-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368815 | Ian Carter Mccormick | Pharmacist | 2710 Maynardville Highway, Maynardville, TN 37807 | 2020-08-25 |
| 1053963975 | Maynardville Drug LLC | Pharmacy | 2975 Maynardville Hwy, Maynardville, TN 37807 | 2019-07-11 |
| 1811014533 | Leah Renee Lewis | Specialist/Technologist | 108 Harmon Drive, Maynardville, TN 37807 | 2007-03-26 |
| 1659497394 | Mohammad Bhidya Md PC | Nurse Practitioner | 2595 Maynardville Hwy, Maynardville, TN 37807 | 2007-03-22 |
| 1053350363 | Thomas J Demaro | Emergency Medicine | 598 John Deere Drive, Maynardville, TN 37807 | 2006-06-05 |
| 1881117521 | Kristy Michille Bolt | Registered Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807 | 2017-07-25 |
| 1275986333 | Ashley Nicole Russell | Counselor | 4330 Maynardville Hwy, Maynardville, TN 37807 | 2016-07-13 |
| 1134504764 | East Tennessee Physical Therapy,llc | Clinic/Center | 4357 Maynardville Hwy, Maynardville, TN 37807 | 2015-07-24 |
| 1962843409 | Mary Elizabeth Phillips | Social Worker | 4330 Maynardville Hwy, Maynardville, TN 37807 | 2013-07-12 |
| 1447500731 | Julie M Roberts | Pharmacist | 4344 Maynardville Hwy, Maynardville, TN 37807 | 2012-09-13 |
| Find all providers in zip 37807 | ||||
| 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 |
|---|---|---|---|---|
| 1053963975 | Maynardville Drug LLC | Pharmacy | 2975 Maynardville Hwy, Maynardville, TN 37807 | 2019-07-11 |
| 1073038121 | Walgreen Co | Pharmacy | 2710 Maynardville Hwy, Maynardville, TN 37807-3021 | 2017-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 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 | ||||
| City | MAYNARDVILLE |
| Zip Code | 37807 |
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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.