Active NPI
Shellnuts Aces Inc
- Community/Retail Pharmacy
- Livingston, TN
National Provider Identifier
1245586031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- SHELLNUTS ACES INC
- Doing business as
- R & M FAMILY PHARMACY
- Practice address
- 1970 Bradford Hicks Dr
Ste B
Livingston, TN 38570 - Phone
- (931) 403-2552
- Fax
- (931) 403-2556
- NPI assigned
- Jul 30, 2012
- 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
- Jonathan Melton
- Title
- Pharmacist
- Phone
- (931) 403-2552
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1970 Bradford Hicks Dr
Ste B
Livingston, TN 38570
Mailing address
PO Box 375
Livingston, TN 38570-0375
Phone (931) 403-2552
Other names 1
- R & M FAMILY PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130114000254 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 7719136431 | Practice locations: Livingston, TN |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Shellnuts Aces Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Livingston, TN
- NPI 1326527078
-
- Community/Retail Pharmacy
- Livingston, TN
- NPI 1497010623
-
- Community/Retail Pharmacy
- Livingston, TN
- NPI 1790052157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1533859200000",
"number": "1245586031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 375",
"city": "LIVINGSTON",
"state": "TN",
"postal_code": "385700375",
"telephone_number": "931-403-2552",
"fax_number": "931-403-2556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 BRADFORD HICKS DR",
"address_2": "STE B",
"city": "LIVINGSTON",
"state": "TN",
"postal_code": "38570",
"telephone_number": "931-403-2552",
"fax_number": "931-403-2556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHELLNUTS ACES INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-30",
"last_updated": "2018-08-10",
"status": "A",
"authorized_official_last_name": "MELTON",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "931-403-2552"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "R & M FAMILY PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "R & M FAMILY PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Livingston, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.