Mac'S Pharmacy at Brown'S Creek, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0000000664 Issued in TN

Legal business name

MAC'S PHARMACY AT BROWN'S CREEK, LLC

Practice address

1612 E. Lamar Alexander Parkway
Maryville, TN 37804

Phone

(865) 982-7162

Fax

(865) 977-4263

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Michael Wilholt, PHARM D

Title

President

Phone

(865) 806-6453

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• City Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Tax ID family

Caldwell Wilhoit Inc2 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.

• Mac'S Pharmacy at Brown'S Creek, LLC

  • Long Term Care Pharmacy
  • Maryville, TN
  • NPI 1518656586
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randal Scott Jenkins, PHARM.D

  • Pharmacist
  • Maryville, TN
  • NPI 1104858828
  NPD (past)
• Anthony Paul Long, RPH

  • Pharmacist
  • Maryville, TN
  • NPI 1366534265
  NPD (past)
• Jeremy P Long, PHARM.D.

  • Basic Emergency Medical Technician
  • Maryville, TN
  • NPI 1447200381
  NPD (past)
• Carol Ann Wilson, PHARMD

  • Pharmacist
  • Nashville, TN
  • NPI 1144864976
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1205933140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 E. LAMAR ALEXANDER PARKWAY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-982-7162",
            "fax_number": "865-977-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 E. LAMAR ALEXANDER PARKWAY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-982-7162",
            "fax_number": "865-977-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAC'S PHARMACY AT BROWN'S CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "WILHOLT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-806-6453",
        "authorized_official_credential": "PHARM D"
    },
    "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": "0000000664",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2088358",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9440097",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452244",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Lustgarten, LPC-MHSP
• Luxottica of America Inc.
• William Elwyn Lyles, MD
• Jessica Lynch
• M. Salerno & Associates, Inc.
• Mac'S Pharmacy at Brown'S Creek, LLC
• Leah Brooke Macaulay, APRN-PMHNP
• Ian Gordon Macleod
• Christina Magnus, LMFT
• Shirley Maguire

• All providers in Maryville, TN
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.