Organization Active NPI

Graves Family Pharmacy

  • Community/Retail Pharmacy
  • McMinnville, TN
National Provider Identifier
1467061952
Registry record updated Feb 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
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

Updated by the provider on Feb 7, 2021

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
Q062108MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
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 Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.