NPIMap

Organization Active NPI

Nuckolls Drug Stores, Inc

Doing business as Hudson Drug Store

  • Pharmacy
  • Bolivar, TN
National Provider Identifier
1437160082
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
128 Issued in TN
Legal business name
NUCKOLLS DRUG STORES, INC
Doing business as
Hudson Drug Store
Practice address
600 Nuckolls Rd
Bolivar, TN 38008-2393
Phone
(731) 658-5207
Fax
(731) 658-1758
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Authorized official

Name
James Kim NuckollsNPI 1043363484
Title
Pres
Phone
(731) 658-5207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 128 TN Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

600 Nuckolls Rd
Bolivar, TN 38008-2393

Mailing address

600 Nuckolls Rd
Bolivar, TN 38008-2393
Phone (731) 658-5207

Other identifiers 1

IdentifierTypeStateIssuer
4401600OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Hudson Drug Store Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1437160082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082393",
            "telephone_number": "731-658-5207",
            "fax_number": "731-658-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082393",
            "telephone_number": "731-658-5207",
            "fax_number": "731-658-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUCKOLLS DRUG STORES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "NUCKOLLS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "731-658-5207"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "128",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4401600",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 11, 2012; 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.