TENNESSEE CVS PHARMACY LLC (NPI# 1710080445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710080445 |
| Entity Type | Organization |
| Organization Name | TENNESSEE CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #07639 |
| Practice Address |
5215 Memorial Blvd Suite 20 Kingsport TN 37664 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 4232797430 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2011-06-28 |
| Authorized Official Name | SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 3237 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4431158 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #07639 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487003877 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 11563 Old Nashville Hwy, Smyrna, TN 37167-3525 | 2016-06-07 |
| 1073997177 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2300 Lake Road, Dyersburg, TN 38024-0000 | 2015-07-17 |
| 1184980575 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6670 Stage Road, Bartlett, TN 38134 | 2012-04-10 |
| 1801167408 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3502 Park Avenue, Memphis, TN 38111-5622 | 2012-01-13 |
| 1992076590 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1405 N Highland Ave, Jackson, TN 38301-3496 | 2012-01-13 |
| 1346544921 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 786 N Germantown Pkwy, Cordova, TN 38018-6212 | 2010-12-22 |
| 1497060834 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3171 Lebanon Pike, Nashville, TN 37214-2314 | 2010-08-10 |
| 1184936106 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6620 Winchester Rd, Memphis, TN 38115-4336 | 2010-07-07 |
| 1568623981 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4058 Franklin Road, Murfreesboro, TN 37128 | 2008-06-18 |
| 1871779892 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1033 Crossing Blvd, Spring Hill, TN 37174 | 2008-01-22 |
| Street Address |
5215 MEMORIAL BLVD SUITE 20 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1861966525 | Catherine Ann Hensley | Nurse Practitioner | 2995 Fort Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-16 |
| 1679076954 | Christopher A Hillman | Dentist | 1599 Fort Henry Dr Ste 102, Kingsport, TN 37664 | 2018-03-13 |
| 1154666733 | Cristin Patterson | Counselor | 2762 East Center St., Kingsport, TN 37664 | 2012-12-07 |
| 1972851095 | Kevin Michael Smith | Pharmacist | 1425 East Center Street, Kingsport, TN 37664 | 2012-08-21 |
| 1619299617 | Kelli Lynn Dillon | Counselor | 1570 Waverly Rorad, Kingsport, TN 37664 | 2010-02-18 |
| 1356503726 | Charles Craig Stieler | Hearing Instrument Specialist | 2101 Ft Henry Dr, Kingsport, TN 37664 | 2008-06-27 |
| 1104012319 | Pro Balance LLC | Prosthetic/Orthotic Supplier | 2408 Fort Henry Drive, Kingsport, TN 37664 | 2007-09-20 |
| 1518188648 | Remington House | Assisted Living Facility | 640 Rock Springs Road, Kingsport, TN 37664 | 2007-05-02 |
| 1689795007 | Elaine Frazier | Emergency Medicine | 410 Golf Ridge Dr, Kingsport, TN 37664 | 2007-04-03 |
| Find all providers in zip 37664 | ||||
| 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 |
|---|---|---|---|---|
| 1740809292 | Kerri Elizabeth Jones | Pharmacy | 404 Red Cedar Branch Rd, Kingsport, TN 37664-5049 | 2020-04-14 |
| 1386085132 | Premier Pharmacy Inc | Pharmacy | 109 Jack White Dr, Kingsport, TN 37664-2364 | 2013-07-09 |
| 1447549241 | K-va-t Food Stores Inc | Pharmacy | 300 Clinchfield Street, Kingsport, TN 37660-3604 | 2011-04-01 |
| 1811015928 | Cave's Drug Store Inc. | Pharmacy | 1328 S Jb Dennis Hwy Ste A, Kingsport, TN 37660-5495 | 2007-03-27 |
| 1871610220 | City Drug L.l.c | Pharmacy | 1624 E Stone Dr, Kingsport, TN 37660-4661 | 2007-03-23 |
| 1710093919 | Halsey Drug LLC | Pharmacy | 1901 Brookside Rd, Kingsport, TN 37660-4601 | 2006-08-21 |
| 1780695353 | P & S Pharmacy | Pharmacy | 613 Watauga St, Kingsport, TN 37660-4429 | 2006-08-10 |
| 1881611234 | K Va T Food Stores Inc | Pharmacy | 1205 N Eastman Rd, Crown Point Center, Kingsport, TN 37664-3145 | 2006-07-15 |
| 1437183167 | Kroger Limited Partnership I | Pharmacy | 1664 E Stone Dr, Kingsport, TN 37660-4663 | 2006-07-10 |
| 1386621696 | Berrys Pharmacy, Inc. | Pharmacy | 1717 Fort Henry Dr, Kingsport, TN 37664-3228 | 2005-12-28 |
| Find all providers in KINGSPORT | ||||
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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.