Whitwell Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00000598 Issued in TN

Legal business name

WHITWELL PHARMACY INC

Practice address

13810 Highway 28
Whitwell, TN 37397-5365

Phone

(423) 658-6939

Fax

(423) 658-0834

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Jacob Standefer

Title

Owner/ Pharmacist

Phone

(423) 877-3568

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WHITWELL PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jarrett Kilgore

  • Pharmacist
  • Whitwell, TN
  • NPI 1609606706
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1477627768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "WHITWELL",
            "state": "TN",
            "postal_code": "373970250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13810 HIGHWAY 28",
            "city": "WHITWELL",
            "state": "TN",
            "postal_code": "373975365",
            "telephone_number": "423-658-6939",
            "fax_number": "423-658-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITWELL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "STANDEFER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER/ PHARMACIST",
        "authorized_official_telephone_number": "423-877-3568"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "00000598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454266",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2089515",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WHITWELL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WHITWELL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Whitwell Medical Plaza
• Whitwell Senior Living, LLC

• All providers in Whitwell, TN
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.