Active NPI
Marcum'S Pharmacy, Inc
- Pharmacy
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 510
- Legal business name
- MARCUM'S PHARMACY, INC
- Practice address
- 902 Broad St
Kingsport, TN 37660-3815 - Phone
- (423) 246-6166
- Fax
- (423) 246-9259
- NPI assigned
- Oct 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Colton N Marcum, RPH
- Title
- Owner
- Phone
- (423) 246-6166
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 510 | TN | Primary |
Addresses
Primary practice location
902 Broad St
Kingsport, TN 37660-3815
Mailing address
902 Broad St
Kingsport, TN 37660-3815
Phone (423) 246-6166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120328000321 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 5991825549 | Practice locations: Kingsport, TN |
| O20210824002927 | TN | Part B Supplier - Independent Clinical Laboratory | 5991825549 | Practice locations: Kingsport, TN |
National Provider Directory
National Provider DirectoryLocations
121 E Ravine Rd
Ste 100
Kingsport, TN 37660
Phone (423) 246-6166
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Long Term Care Pharmacy
- Kingsport, TN
- NPI 1275231052
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Kingsport, TN
- NPI 1902243496
-
- Pharmacist
- Kingsport, TN
- NPI 1790122281
-
- Pharmacist
- Kingsport, TN
- NPI 1598388209
-
- Pharmacist
- Kingsport, TN
- NPI 1023119047
-
- Pharmacist
- Kingsport, TN
- NPI 1942611009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1630281600000",
"number": "1245315522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 BROAD ST",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603815",
"telephone_number": "423-246-6166",
"fax_number": "423-246-9259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 BROAD ST",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603815",
"telephone_number": "423-246-6166",
"fax_number": "423-246-9259"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARCUM'S PHARMACY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-26",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A",
"authorized_official_last_name": "MARCUM",
"authorized_official_first_name": "COLTON",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "423-246-6166",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TN",
"license": "510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.