Clarksville Pharmacy I LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

TN1567 Issued in KY

Legal business name

CLARKSVILLE PHARMACY I LLC

Doing business as

Andy's Pharmacy

Practice address

801 N 2ND St
Clarksville, TN 37040-2909

Phone

(931) 802-5386

Fax

(931) 802-5389

NPI assigned

May 27, 2009

Last updated

Aug 18, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew Hirt

Title

Administrator

Phone

(615) 330-8485

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Andy's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Tax ID family

Andy's Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Clarksville Pharmacy I LLC

  dba Andy's Pharmacy

  • Long Term Care Pharmacy
  • Clarksville, TN
  • NPI 1518250141
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Hester Muiznieks, RPH

  • Pharmacist
  • Clarksville, TN
  • NPI 1417189747
  NPD (past)
• David George Muiznieks, RPH

  • Pharmacist
  • Clarksville, TN
  • NPI 1144452475
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1023243672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 BALDWIN ARBOR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152412",
            "telephone_number": "931-802-5386",
            "fax_number": "931-802-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N 2ND ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370402909",
            "telephone_number": "931-802-5386",
            "fax_number": "931-802-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE PHARMACY I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "HIRT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "615-330-8485"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "4647",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "TN1567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515313",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100199100",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andy's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Andy's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clarksville Psychological Services

• Community/Retail Pharmacy in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.