Jeffco Rutledge Drugs
Organization Active NPI Pharmacist · Rutledge, TN
NPI 1417018698 · NPPES record last updated Mar 17, 2015
Key facts
- NPI
- 1417018698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- 23997 (TN)
- Legal business name
- JEFFCO RUTLEDGE DRUGS
- Practice address
- 8120 Rutledge Pike
Rutledge, TN 37861-0406 - Phone
- (865) 828-5222
- Fax
- (865) 828-5959
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Jill Cabbage
- Title
- Pharmacist in Charge/Owner
- Phone
- (865) 828-5222
Practitioners 1
-
Jill Susan Cabbage, PHARM.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Smith Drug Store |
Nebulizer Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Nebulizer Equipment and/or Supplies | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930090849 | TN | DME Supplier - Pharmacy | 3577683978 | Practice locations: Rutledge, TN |
| O20180829004209 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 3577683978 | Practice locations: Rutledge, TN |
National Provider Directory
Locations
8120 Rutledge Pike
Rutledge, TN 37861
Phone (865) 828-5222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 23997 | TN | Yes |
Addresses
Primary practice location
8120 Rutledge Pike
Rutledge, TN 37861-0406
Mailing address
PO Box 406
Rutledge, TN 37861-0406
Phone (865) 828-5222
Other names
- Smith Drug Store
Other providers in Rutledge, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.