JJ Beans at Mooneys LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1663 Issued in TN

Legal business name

JJ BEANS AT MOONEYS LLC

Practice address

1107 N Roan St
Johnson City, TN 37601-3901

Phone

(423) 926-7333

NPI assigned

May 14, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Chad B Huntsman, PHARMD

Title

Owner

Phone

(423) 312-3856

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mooney's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Tax ID family

JJ Beans at Mooneys LLC2 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.

• JJ Beans at Mooneys LLC

  • Long Term Care Pharmacy
  • Johnson City, TN
  • NPI 1386244085
  NPD tax ID

Locations

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1477043768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013901",
            "telephone_number": "423-926-7333",
            "fax_number": "423-926-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N ROAN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013901",
            "telephone_number": "423-926-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJ BEANS AT MOONEYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "HUNTSMAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-312-3856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "1663",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "TN",
            "license": "1663",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037654",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mooney's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mooney's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Seth Michael Jewett
• Ethan Jilek
• Luisa Jimenez-Ruble, PSYD
• Mary Rebekah Jimenez
• JJ Beans at Mooneys LLC
• John Lawson Surgical Group
• John Lawson Surgical Group, PC
• John Marshall Jewett DMD PLLC
• John McClellan Miller, MD
• Emmanuel Steven John, LCSW

• Community/Retail Pharmacy in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.