Anderson & Haile Drug Store
Organization Active NPI Community/Retail Pharmacy · Gainesboro, TN
NPI 1194748566 · NPPES record last updated Jan 29, 2019
Key facts
- NPI
- 1194748566
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 0000000378 (TN)
- Legal business name
- ANDERSON & HAILE DRUG STORE
- Practice address
- 101 West Gore Ave
Gainesboro, TN 38562 - Phone
- (931) 268-0233
- Fax
- (931) 268-2183
- NPI assigned
- Jul 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Teneal Jenkins, PHARMD
- Title
- Owner
- Phone
- (931) 268-0233
Practitioners 1
-
Teneal Faye Jenkins, PHARMD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Anderson and Haile Drug Store |
Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manu… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080226000707 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 8921182171 | Practice locations: Gainesboro, TN |
| O20100930092646 | TN | DME Supplier - Pharmacy | 8921182171 | Practice locations: Gainesboro, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 0000000378 | TN | Yes |
Addresses
Primary practice location
101 West Gore Ave
Gainesboro, TN 38562
Mailing address
PO Box 65
Gainesboro, TN 38562-0065
Phone (931) 268-0233
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4400557 | Medicaid | TN | |
| 4400557 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- Teneal Jenkins
Other providers in Gainesboro, TN
All providers in Gainesboro, TN · Community/Retail Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.