NPIMap

Organization Active NPI

Georg E Hooton & Robert K Galloway III PTR Manor Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Hermitage, TN
National Provider Identifier
1174670129
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0000000688 Issued in TN
Legal business name
GEORG E HOOTON & ROBERT K GALLOWAY III PTR MANOR PHARMACY
Practice address
4343 Lebanon Pike
Suite #114
Hermitage, TN 37076-1221
Phone
(615) 883-5169
Fax
(615) 889-9733
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mr. George Edward Hooten, DPH
Title
Owner
Phone
(615) 883-5522

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0000000688 TN Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 0000000688 TN
Oxygen Equipment & Supplies (DME) 332BX2000X 0000000688 TN

Addresses

Primary practice location

4343 Lebanon Pike
Suite #114
Hermitage, TN 37076-1221

Mailing address

4343 Lebanon Pike
Suite #100
Hermitage, TN 37076-1221
Phone (615) 883-5522

Other identifiers 1

IdentifierTypeStateIssuer
68401MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Georg E Hooton Robert K Galloway III PTR Manor Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1174670129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 LEBANON PIKE",
            "address_2": "SUITE #100",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761221",
            "telephone_number": "615-883-5522",
            "fax_number": "615-885-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 LEBANON PIKE",
            "address_2": "SUITE #114",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761221",
            "telephone_number": "615-883-5169",
            "fax_number": "615-889-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORG E HOOTON & ROBERT K GALLOWAY III PTR MANOR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "HOOTEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-883-5522",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000688",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TN",
            "license": "0000000688",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TN",
            "license": "0000000688",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68401",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.