MAC'S MEDICINE MART, INC (NPI# 1760580609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760580609 |
| Entity Type | Organization |
| Organization Name | MAC'S MEDICINE MART, INC |
| Practice Address |
1455 E Center St Kingsport TN 37664-2501 |
| Practice Telephone | 4232452181 |
| Practice Fax Number | 4232457261 |
| Mailing Telephone | 4232452181 |
| Mailing Fax Number | 4232457261 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | DR. BARRY WALTON (PRESIDENT) |
| Authorized Official Telephone | 4232452181 |
| Authorized Official Credential | D.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 0417510001 | TN | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2008 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | NCPDP | 4424824 | 01 |
| TN | DEA | BM1987203 | 01 |
| Street Address |
1455 E CENTER ST |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377030 | Vickie Wilhoit | Pharmacy Technician | 1455 E Center St, Kingsport, TN 37664-2501 | 2020-05-16 |
| 1457451965 | Barry Walton | Pharmacist | 1455 E Center St, Kingsport, TN 37664-2501 | 2006-09-24 |
| 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 | 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 |
|---|---|---|---|---|
| 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 | ||||
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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.