Robert D Mitchell

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1107 Issued in TN

Legal business name

ROBERT D MITCHELL

Practice address

133 W Court Ave
Selmer, TN 38375-2130

Phone

(731) 645-5391

Fax

(731) 645-5391

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Robert Mitchell, DPH

Title

Owner

Phone

(731) 645-5591

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SELMER DRUG COMPANY Doing business as

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1376609255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W COURT AVE",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W COURT AVE",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752130",
            "telephone_number": "731-645-5391",
            "fax_number": "731-645-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D MITCHELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-645-5591",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "1107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2096004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3519165",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SELMER DRUG COMPANY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Selmer Smiles

• All providers in Selmer, TN
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.