Active NPI
Graves Family Pharmacy
- Community/Retail Pharmacy
- McMinnville, TN
National Provider Identifier
1467061952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- GRAVES FAMILY PHARMACY
- Practice address
- 357 W Main St
McMinnville, TN 37110-2519 - Phone
- (931) 473-6418
- Fax
- (931) 304-2828
- NPI assigned
- Jul 30, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Emily Graves, PHARM D
- Title
- Owner
- Phone
- (931) 473-6418
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
357 W Main St
McMinnville, TN 37110-2519
Mailing address
357 W Main St
McMinnville, TN 37110-2519
Phone (931) 473-6418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q062108 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210315000382 | TN | Part B Supplier - Pharmacy | 5395151591 | Practice locations: McMinnville, TN |
| O20210401001440 | TN | Part B Supplier - Independent Clinical Laboratory | 5395151591 | Practice locations: McMinnville, TN |
| O20211208002479 | TN | DME Supplier - Pharmacy | 5395151591 | Practice locations: McMinnville, TN |
National Provider Directory
National Provider Directory- Tax ID family
- Graves Family Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- McMinnville, TN
- NPI 1669187811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612656000000",
"number": "1467061952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 W MAIN ST",
"city": "MCMINNVILLE",
"state": "TN",
"postal_code": "371102519",
"telephone_number": "931-473-6418",
"fax_number": "931-304-2828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "357 W MAIN ST",
"city": "MCMINNVILLE",
"state": "TN",
"postal_code": "371102519",
"telephone_number": "931-473-6418",
"fax_number": "931-304-2828"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAVES FAMILY PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-30",
"last_updated": "2021-02-07",
"certification_date": "2021-02-07",
"status": "A",
"authorized_official_last_name": "GRAVES",
"authorized_official_first_name": "EMILY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "931-473-6418",
"authorized_official_credential": "PHARM D"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q062108",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in McMinnville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.