River Valley Phcy and Supply LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

3638 Issued in TN

Legal business name

RIVER VALLEY PHCY AND SUPPLY LLC

Practice address

58 S Main St
Lexington, TN 38351-2104

Phone

(731) 968-2661

Fax

(731) 968-3230

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

John Simonton

Title

President

Phone

(731) 968-2661

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033120613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 S MAIN ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383512104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 S MAIN ST",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383512104",
            "telephone_number": "731-968-2661",
            "fax_number": "731-968-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER VALLEY PHCY AND SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMONTON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-968-2661"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "3638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4434851",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4434851",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin B Record, LPC
• Olivia Grace Reddix, RBT
• Toni M Reed, NP
• Micah Magdalyn Reeves, RBT
• Brandy Rhodes, BS
• S D M Inc
• Natasha Scates, BS
• Chad C Scott, FNP MSN
• Scotts Hill Clinic, Inc.
• Rachel L Segars, PT

• Long Term Care Pharmacy in Lexington, TN
• Providers in Lexington, TN by specialty
• Long Term Care Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.