Active NPI
Morgan Gillenwater
- Pharmacist
- Bristol, TN
National Provider Identifier
1124430483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0203015577
- Practice address
- 2412 W State St
Bristol, TN 37620-1836 - Phone
- (423) 764-3261
- NPI assigned
- May 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0203015577 | VA | Primary |
Addresses
Primary practice location
2412 W State St
Bristol, TN 37620-1836
Mailing address
2412 W State St
Bristol, TN 37620-1836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0203015577 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LW Pharmaceuticals Inc | Current | Accepting new patients | |
| LW Pharmaceuticals Inc | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Life Well Pharmacy
- Community/Retail Pharmacy
- Richlands, VA
- NPI 1962367359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1124430483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2412 W STATE ST",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376201836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2412 W STATE ST",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376201836",
"telephone_number": "423-764-3261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLENWATER",
"first_name": "MORGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-21",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0203015577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.