Active NPI
Jarrod Allen Tidwell, PHARM D
- Pharmacist
- Cottonwood, AL
National Provider Identifier
1437230539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS36356
- Practice address
- 12890 Cottonwood Rd
Cottonwood, AL 36320-4293 - Phone
- (334) 691-3784
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 | PS36356 | FL | Primary |
Addresses
Primary practice location
12890 Cottonwood Rd
Cottonwood, AL 36320-4293
Mailing address
PO Box 85
Malone, FL 32445-0085
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS36356 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cottonwood Drugs LLC | Current | Accepting new patients |
Locations
12890 Cottonwood Rd
Cottonwood, AL 36320
Phone (334) 691-3784
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
- Cottonwood, AL
- NPI 1124467402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1437230539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 85",
"city": "MALONE",
"state": "FL",
"postal_code": "324450085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12890 COTTONWOOD RD",
"city": "COTTONWOOD",
"state": "AL",
"postal_code": "363204293",
"telephone_number": "334-691-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "JARROD",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS36356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottonwood, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.