Cookeville Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4863 Issued in TN

Legal business name

COOKEVILLE PHARMACY LLC

Doing business as

Andy's Pharmacy

Practice address

305 W Spring St
Cookeville, TN 38501-3125

Phone

(931) 372-2700

Fax

(931) 372-2701

NPI assigned

Mar 31, 2011

Last updated

Dec 1, 2021By 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

Laura Davis Hirt

Title

Owner

Phone

(931) 372-2700

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Andy's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1154610038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 HARDING PIKE APT 123",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052174",
            "telephone_number": "931-372-2700",
            "fax_number": "931-372-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W SPRING ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013125",
            "telephone_number": "931-372-2700",
            "fax_number": "931-372-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOKEVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "HIRT",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-372-2700"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "4863",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154610038M",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2129702",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andy's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Andy's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cookeville Pharmacy LLC (Andy's Pharmacy)
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• Cookeville Regional Dental Associates
• Cookeville Regional Dental Inc

• Community/Retail Pharmacy in Cookeville, TN
• Providers in Cookeville, 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 Dec 1, 2021; 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.