NPIMap

Organization Active NPI

Phipps Pharmacy Inc

Doing business as Phipps Pharmacy #2

  • Community/Retail Pharmacy
  • Bruceton, TN
National Provider Identifier
1154487429
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0146 Issued in TN
Legal business name
PHIPPS PHARMACY INC
Doing business as
Phipps Pharmacy #2
Practice address
121 Maple St
Bruceton, TN 38317-1819
Phone
(731) 586-2931
Fax
(731) 352-2848
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Authorized official

Name
Jerry Phipps, PHARMD
Title
President Ceo
Phone
(731) 352-0820

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 0146 TN Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

121 Maple St
Bruceton, TN 38317-1819

Mailing address

205B Hospital Dr
MC Kenzie, TN 38201-1649
Phone (731) 352-0820

Other identifiers 2

IdentifierTypeStateIssuer
1455149MedicaidTN
4404644OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • PHIPPS PHARMACY #2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phipps Pharmacy 34 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

121 Maple St
Bruceton, TN 38317
Phone (731) 586-2931

Practitioners & affiliated clinicians

Practitioners 1

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": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1154487429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205B HOSPITAL DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-0820",
            "fax_number": "731-352-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MAPLE ST",
            "city": "BRUCETON",
            "state": "TN",
            "postal_code": "383171819",
            "telephone_number": "731-586-2931",
            "fax_number": "731-352-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHIPPS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "731-352-0820",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "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": "0146",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455149",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4404644",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHIPPS PHARMACY #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bruceton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.