Riddle and Wallace Drug

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

116 Issued in TN

Legal business name

RIDDLE AND WALLACE DRUG

Practice address

8 Washington Ave
Athens, TN 37303

Phone

(423) 745-3383

Fax

(423) 745-3358

NPI assigned

Sep 14, 2006

Last updated

Jun 5, 2008By 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

Jack Wallace

Title

Pharmacist and Owner

Phone

(423) 745-3382

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1083719843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373710569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WASHINGTON AVE",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "37303",
            "telephone_number": "423-745-3383",
            "fax_number": "423-745-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDDLE AND WALLACE DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "423-745-3382"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3540727",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4404341",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cheryl Ann Roberts, FNP
• Sarah Elizabeth Roberts, DPT

• Community/Retail Pharmacy in Athens, TN
• Providers in Athens, 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 Jun 5, 2008; 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.