Marks Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1352 Issued in TN

Legal business name

MARKS PHARMACY

Practice address

106 Creek St
Lake City, TN 37769

Phone

(865) 426-2186

Fax

(865) 426-9200

NPI assigned

Dec 8, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark SmithNPI 1235322181

Title

President Ceo

Phone

(865) 426-2186

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

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.

• Mark Thomas Smith, PA-C

  • Medical Physician Assistant
  • Lake City, TN
  • NPI 1235322181
  NPD (past) Authorized official
• Wendy Braden Miller, NP-C

  • Nurse Practitioner
  • Lake City, TN
  • NPI 1659691418
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1285793653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1035",
            "city": "LAKE CITY",
            "state": "TN",
            "postal_code": "377691035",
            "telephone_number": "865-300-8084",
            "fax_number": "865-426-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CREEK ST",
            "city": "LAKE CITY",
            "state": "TN",
            "postal_code": "37769",
            "telephone_number": "865-426-2186",
            "fax_number": "865-426-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "865-426-2186"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "1352",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3910029",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP-DME",
            "identifier": "4440412",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP-PHARMACY",
            "identifier": "4408173",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corner Drug Co Inc
• David Carl Dew, R.P.H.
• Marks Pharmacy
• Wendy Braden Miller, NP-C
• Ronald E. Noe, D.D.S.
• Mark Thomas Smith, PA-C
• Sheila Marie Sparks, OT

• Community/Retail Pharmacy in Lake City, TN
• Providers in Lake City, 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 Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.