MAC'S MEDICINE MART DBA UNIQUE BOUTIQUE


Address: 1455 E Center St Ste 2b, Kingsport, TN 37664-2501
Phone: 4232462646

MAC'S MEDICINE MART DBA UNIQUE BOUTIQUE (NPI# 1841761947) 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) 1841761947
Entity Type Organization
Organization Name MAC'S MEDICINE MART DBA UNIQUE BOUTIQUE
Other Organization Name UNIQUE BOUTIQUE
Practice Address 1455 E Center St Ste 2b
Kingsport
TN 37664-2501
Practice Telephone 4232462646
Practice Fax Number 4237659111
Mailing Telephone 4232462646
Mailing Fax Number 4237659111
Enumeration Date 2018-12-16
Last Update Date 2019-07-19
Authorized Official Name DR. BARRY WALTON (PRESIDENT)
Authorized Official Telephone 4232452181
Authorized Official Credential DPH
Is Organization Subpart Y
Parent Organization Name MAC'S MEDICINE MART, INC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335E00000X Prosthetic/Orthotic Supplier Suppliers

Other Provider/Organization Names

Other Name Type Code
Unique Boutique Doing Business As Name - Organization

Office Location

Street Address 1455 E CENTER ST STE 2B
City KINGSPORT
State TN
Zip Code 37664-2501

Providers in the same zip code

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 Information

Taxonomy Code 335E00000X
Grouping Suppliers
Classification Prosthetic/Orthotic Supplier

Taxonomy Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023368180 Achieve Bracing Prosthetic/Orthotic Supplier 1732 N Eastman Rd Ste 1a, Kingsport, TN 37664-2376 2012-09-17
1154653830 Southern Orthotics & Prosthetics Prosthetic/Orthotic Supplier 1567 N Eastman Rd Ste 4, Kingsport, TN 37664-2680 2010-02-05
1104012319 Pro Balance LLC Prosthetic/Orthotic Supplier 2408 Fort Henry Drive, Kingsport, TN 37664 2007-09-20
1740373661 Jason D Joyce Prosthetic/Orthotic Supplier 1567 N Eastman Rd, Suite 4, Kingsport, TN 37664-2683 2006-10-02
1528167509 Custom Orthotics & Prosthetics Prosthetic/Orthotic Supplier 1567 North Eastman Rd, Ste 4, Kingsport, TN 37664-2680 2006-09-22
1982670964 Appalachian Prosthetic & Orthotic Services, Inc Prosthetic/Orthotic Supplier 3551 E Stone Dr, Kingsport, TN 37660-7115 2006-02-28
1992257745 Excel Prosthetics & Orthotics, Inc Prosthetic/Orthotic Supplier 121 E Ravine Rd, Suite 400, Kingsport, TN 37660 2016-10-27
1437563665 Bristol Orthotics & Prosthetics, Inc Prosthetic/Orthotic Supplier 921 Broad St, Kingsport, TN 37660-3801 2014-06-16
1518238278 Finer Things for Her Prosthetic/Orthotic Supplier 1880 N Eastman Rd, Suite 230, Kingsport, TN 37664-2312 2012-01-25
1891935763 Victory Orthotics & Prosthetics LLC Prosthetic/Orthotic Supplier 2 Sheridan Sq, Suite 100, Kingsport, TN 37660 2009-03-04
Find all providers in KINGSPORT

Competitor

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City KINGSPORT
Zip Code 37664

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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