NUCKOLLS DRUG STORES, INC (NPI# 1437160082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437160082 |
Entity Type | Organization |
Organization Name | NUCKOLLS DRUG STORES, INC |
Other Organization Name | HUDSON DRUG STORE |
Practice Address |
600 Nuckolls Rd Bolivar TN 38008-2393 |
Practice Telephone | 7316585207 |
Practice Fax Number | 7316581758 |
Mailing Telephone | 7316585207 |
Mailing Fax Number | 7316581758 |
Enumeration Date | 2006-08-10 |
Last Update Date | 2012-12-11 |
Authorized Official Name | JAMES KIM NUCKOLLS (PRES) |
Authorized Official Telephone | 7316585207 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
Y | 333600000X | Pharmacy | 128 | TN | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OTHER ID NUMBER-COMMERCIAL NUMBER | 4401600 | 01 |
Other Name | Type Code |
---|---|
Hudson Drug Store | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013068220 | Nuckolls Drug Stores, Inc | Pharmacy | 407 W Lafayette St, Bolivar, TN 38008-2651 | 2007-01-15 |
Street Address |
600 NUCKOLLS RD |
City | BOLIVAR |
State | TN |
Zip Code | 38008-2393 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730724493 | Hudson Drug Store, LLC | Pharmacy | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2019-11-16 |
1306212162 | Jason Carter | Pharmacist | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2015-08-17 |
1265878557 | Freds Stores of Tennessee Inc. | Pharmacy | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2013-05-14 |
1043363484 | James Kim Nuckolls | Pharmacist | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-01-19 |
1427109834 | Amanda B Baker | Pharmacist | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-01-13 |
1881745297 | Freeman Hunter Baird Jr. | Pharmacist | 600 Nuckolls Rd, Bolivar, TN 38008-1532 | 2007-01-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
Find all providers in zip 38008 |
Taxonomy Code | 333600000X |
Grouping | Suppliers |
Classification | Pharmacy |
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
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: added definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013021328 | Sparks Pharmacy Inc | Pharmacy | 2000 S Springfield Ave, Bolivar, MO 65613-9654 | 2006-08-17 |
1801809785 | Sparks Pharmacy Inc | Pharmacy | 1001 E Cambridge St, Bolivar, MO 65613-3502 | 2006-08-14 |
1093726630 | Stephens Pharmacy Inc | Pharmacy | 1100 S Springfield Ave, Bolivar, MO 65613-2512 | 2006-08-10 |
1902838840 | Freds Stores of Tennessee Inc | Pharmacy | 105 Tennessee St, Bolivar, TN 38008-1822 | 2006-07-07 |
1255302451 | Citizens Memorial Health Care Foundation | Pharmacy | 1301b N Oakland Ave, Bolivar, MO 65613-3019 | 2006-01-27 |
1073078481 | Southern Express Pharmacy | Pharmacy | 1355 W Market St, Bolivar, TN 38008-1715 | 2019-02-10 |
1801318472 | Citizens Memorial Health Care Foundation | Pharmacy | 1100 S Springfield Ave, Bolivar, MO 65613-2512 | 2017-07-14 |
1639691959 | Citizens Memorial Health Care Foundation | Pharmacy | 1100 S Springfield Ave Ste A, Bolivar, MO 65613 | 2017-07-07 |
1750326195 | Portville Pharmacy Inc | Pharmacy | 323 Main St, Bolivar, NY 14715-1108 | 2006-06-19 |
1598723447 | The Hatchie Pharmacy LLC | Pharmacy | 640 Nuckolls Rd, Bolivar, TN 38008-1532 | 2006-05-02 |
Find all providers in BOLIVAR |
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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.