Active NPI
Carla Staggs
Doing business as Collinwood Drugs
- Community/Retail Pharmacy
- Collinwood, TN
National Provider Identifier
1285747527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 2179
- Legal business name
- CARLA STAGGS
- Doing business as
- Collinwood Drugs
- Practice address
- 313 Hwy 13 South
Collinwood, TN 38450 - Phone
- (931) 724-9197
- Fax
- (931) 724-5381
- NPI assigned
- Aug 17, 2006
- Last updated
- Mar 11, 2016
- 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
- Dr. Carla B Staggs, PHARMD
- Title
- Owner/Pharmacist in Charge
- Phone
- (931) 724-9197
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 2179 | TN | Primary |
Addresses
Primary practice location
313 Hwy 13 South
Collinwood, TN 38450
Mailing address
PO Box 96
313 Hwy 13 South
Collinwood, TN 38450-0096
Phone (931) 724-9197
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113600 | Medicaid | TN | |
| 2179 | Other | TN | STATE PHARMACY BOARD |
Other names 1
- Collinwood Drugs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140210001666 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 0840429015 | Practice locations: Collinwood, TN |
| O20170331000016 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 7618252818 | Practice locations: Collinwood, TN |
National Provider Directory
National Provider Directory- Tax ID family
- Carla Staggs
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Collinwood, TN
- NPI 1114387248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1457654400000",
"number": "1285747527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 96",
"address_2": "313 HWY 13 SOUTH",
"city": "COLLINWOOD",
"state": "TN",
"postal_code": "384500096",
"telephone_number": "931-724-9197",
"fax_number": "931-724-5381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 HWY 13 SOUTH",
"city": "COLLINWOOD",
"state": "TN",
"postal_code": "38450",
"telephone_number": "931-724-9197",
"fax_number": "931-724-5381"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARLA STAGGS",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-17",
"last_updated": "2016-03-11",
"status": "A",
"authorized_official_last_name": "STAGGS",
"authorized_official_first_name": "CARLA",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
"authorized_official_telephone_number": "931-724-9197",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TN",
"license": "2179",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113600",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACY BOARD",
"identifier": "2179",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Collinwood Drugs",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Collinwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.