Cumberland Special Care Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CUMBERLAND SPECIAL CARE PHARMACY LLC

Doing business as

Cumberland Vital Care

Practice address

3106 Miller Ave Ste 101
Crossville, TN 38555-6118

Phone

(931) 456-0680

Fax

(931) 456-4857

NPI assigned

Jun 19, 2015

Organization subpart

No

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

Authorized official

Name

Landon HeadrickNPI 1851063267

Title

Owner/Pic

Phone

(931) 456-0680

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Cumberland Vital Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Tax ID family

Cumberland Special Care Pharmacy LLC2 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.

• Cumberland Special Care Pharmacy LLC

  • Community/Retail Pharmacy
  • Crossville, TN
  • NPI 1750970968
  NPD tax ID

Locations

Practitioners 2

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

• Landon Kyle Headrick, PHARM. D.

  • Pharmacist
  • Crossville, TN
  • NPI 1851063267
  NPD Authorized official
• Rodney Jerome Burney, PHARM.D

  • Pharmacist
  • Crossville, TN
  • NPI 1376215053
  NPD

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1215319892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2809",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385572809",
            "telephone_number": "931-456-0680",
            "fax_number": "931-456-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 MILLER AVE STE 101",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556118",
            "telephone_number": "931-456-0680",
            "fax_number": "931-456-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND SPECIAL CARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "HEADRICK",
        "authorized_official_first_name": "LANDON",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "931-456-0680"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "TN",
            "license": "5708",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q020116",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157234",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cumberland Vital Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cumberland Vital Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cumberland Podiatric Surgeons Inc
• Cumberland Radiology Group PC
• Cumberland Rheumatology
• Cumberland Rheumatology PLLC
• Cumberland Ridge Assisted Living Facility
• Cumberland Special Care Pharmacy LLC
• Cumberland Vital Care, LLC
• Dale Cuva
• Casey Rowan Davidson, D.C.
• Dirk C Davidson, MD

• Community/Retail Pharmacy in Crossville, TN
• Providers in Crossville, 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 Feb 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.