Organization Active NPI

Gean Companies-Clifton, LLC

  • Pharmacist
  • Clifton, TN
National Provider Identifier
1124187802
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
GEAN COMPANIES-CLIFTON, LLC
Practice address
104 Main Street
Clifton, TN 38425
Phone
(931) 676-3318
Fax
(931) 676-3450
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Dr. William McBath Graham, PHARMDNPI 1326703364
Title
Manager/Pharmacist in Charge
Phone
(931) 676-3318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1254 TN
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

104 Main Street
Clifton, TN 38425

Mailing address

PO Box 194
Clifton, TN 38425
Phone (931) 676-3318

Other identifiers 2

IdentifierTypeStateIssuer
3452202MedicaidTN
2095243OtherPK

Other names 1

  • Willoughby Drugs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190201000598 TN Part B Supplier - Pharmacy 4385832385 Practice locations: Clifton, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1124187802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194",
            "city": "CLIFTON",
            "state": "TN",
            "postal_code": "38425",
            "telephone_number": "931-676-3318",
            "fax_number": "931-676-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MAIN STREET",
            "city": "CLIFTON",
            "state": "TN",
            "postal_code": "38425",
            "telephone_number": "931-676-3318",
            "fax_number": "931-676-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEAN COMPANIES-CLIFTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MCBATH",
        "authorized_official_title_or_position": "MANAGER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "931-676-3318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "1254",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3452202",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2095243",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willoughby Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.