Active NPI
Eric Alan Folk, DPH
- Pharmacist
- Bolivar, TN
National Provider Identifier
1336688043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5764
- Practice address
- 629 Nuckolls Rd
Bolivar, TN 38008-1599 - Phone
- (731) 658-5294
- Fax
- (731) 659-3918
- NPI assigned
- Feb 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5764 | TN | Primary |
Addresses
Primary practice location
629 Nuckolls Rd
Bolivar, TN 38008-1599
Mailing address
629 Nuckolls Rd
Bolivar, TN 38008-1599
Phone (731) 658-5294
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5764 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moscow Group LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Germantown, TN
- NPI 1386102796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1336688043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 NUCKOLLS RD",
"city": "BOLIVAR",
"state": "TN",
"postal_code": "380081599",
"telephone_number": "731-658-5294",
"fax_number": "731-659-3918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 NUCKOLLS RD",
"city": "BOLIVAR",
"state": "TN",
"postal_code": "380081599",
"telephone_number": "731-658-5294",
"fax_number": "731-659-3918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLK",
"first_name": "ERIC",
"middle_name": "ALAN",
"credential": "DPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-14",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "5764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolivar, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.