Organization Active NPI

Farragut Pharmacy Inc

  • Pharmacy
  • Knoxville, TN
National Provider Identifier
1225179369
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
210 Issued in TN
Legal business name
FARRAGUT PHARMACY INC
Practice address
11424 Kingston Pike
Knoxville, TN 37934-3915
Phone
(865) 966-9728
Fax
(865) 671-1981
NPI assigned
Feb 10, 2007
Last updated
Mar 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Authorized official

Name
Elizabeth Mary Segraves, PHARMDNPI 1053452193
Title
President
Phone
(865) 966-9728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 210 TN Primary

Addresses

Primary practice location

11424 Kingston Pike
Knoxville, TN 37934-3915

Mailing address

11424 Kingston Pike
Knoxville, TN 37934-3915
Phone (865) 966-9728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201117003141 TN Part B Supplier - Pharmacy 9638354038 Practice locations: Knowville, TN

National Provider Directory

National Provider Directory

Locations

11424 Kingston Pike
Knoxville, TN 37934
Phone (865) 966-9728

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1225179369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11424 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343915",
            "telephone_number": "865-966-9728",
            "fax_number": "865-671-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11424 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343915",
            "telephone_number": "865-966-9728",
            "fax_number": "865-671-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARRAGUT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "SEGRAVES",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-966-9728",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.