Mosheim Drug, LLC
Organization Active NPI Pharmacy · Mosheim, TN
NPI 1467793166 · NPPES record last updated Mar 19, 2020
Key facts
- NPI
- 1467793166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 5152 (TN)
- Legal business name
- MOSHEIM DRUG, LLC
- Practice address
- 6766 West Andrew Johnson Highway
Mosheim, TN 37818 - Phone
- (423) 422-2829
- Fax
- (423) 422-2827
- NPI assigned
- Mar 6, 2013
- Organization subpart
- No
Authorized official
- Name
- Matthew Epling
- Title
- Member
- Phone
- (423) 422-2829
Practitioners 1
-
Ashlie B Epling, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2233051 | Mosheim Drug LLC | Certificate of waiver | Aug 18, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Mosheim Drug LLC |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Ultraviolet Light Device… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130903000733 | TN | DME Supplier - Pharmacy |
9436392867 | Practice locations: Mosheim, TN |
| O20130925000801 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 9436392867 | Practice locations: Mosheim, TN |
National Provider Directory
Locations
1238 E Jackson Blvd
Jonesborough, TN 37659
Phone (423) 753-2441
6766 W Andrew Johnson Hwy
#2
Mosheim, TN 37818
Phone (423) 422-2829
6766 W Andrew Johnson Hwy
Mosheim, TN 37818
Phone (423) 422-2829
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 1131 | TN | |
| Pharmacy | 333600000X | 5152 | TN | Yes |
Addresses
Primary practice location
6766 West Andrew Johnson Highway
Mosheim, TN 37818
Mailing address
1238 East Jackson Blvd
Jonesborough, TN 37659
Phone (423) 422-2829
Other names
- The Medicine Shoppe #1994
Other providers in Mosheim, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2020. 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.