NPIMap

Organization Active NPI

State of Tennessee

  • Clinic Pharmacy
  • Jackson, TN
National Provider Identifier
1386863314
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
443 Issued in TN
Legal business name
STATE OF TENNESSEE
Practice address
295 Summar Dr
Jackson, TN 38301-3905
Phone
(731) 421-6732
Fax
(731) 935-7093
NPI assigned
Apr 25, 2007
Last updated
Sep 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Authorized official

Name
Mrs. Marilyn Barnes
Title
Regional Director
Phone
(731) 421-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 443 TN Primary

Addresses

Primary practice location

295 Summar Dr
Jackson, TN 38301-3905

Mailing address

295 Summar Dr
Jackson, TN 38301-3905
Phone (731) 421-6732

Other names 1

  • West Tennessee Regional Health Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Kingsport Health Center202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

295 Summar Dr
Jackson, TN 38301
Phone (731) 421-6705

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1386863314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013905",
            "telephone_number": "731-421-6732",
            "fax_number": "731-935-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013905",
            "telephone_number": "731-421-6732",
            "fax_number": "731-935-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2010-09-01",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "731-421-6700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "TN",
            "license": "443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Tennessee Regional Health Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.