Lavergne Family Pharmacy PC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5467 Issued in TN

Legal business name

LAVERGNE FAMILY PHARMACY PC

Doing business as

Fichtel Pharmacy
Fichtel's Pharmacy

Practice address

405 Old Nashville Hwy
La Vergne, TN 37086-3332

Phone

(615) 462-6031

NPI assigned

Oct 8, 2014

Last updated

Oct 1, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Caleb Gibbs

Title

VP of Operations

Phone

(615) 462-6031

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 2

• Fichtel Pharmacy Doing business as
• Fichtel's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1487057220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OLD NASHVILLE HWY",
            "city": "LA VERGNE",
            "state": "TN",
            "postal_code": "370863332",
            "telephone_number": "615-462-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OLD NASHVILLE HWY",
            "city": "LA VERGNE",
            "state": "TN",
            "postal_code": "370863332",
            "telephone_number": "615-462-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVERGNE FAMILY PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "615-462-6031"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "5467",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148227",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fichtel Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fichtel's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fichtel's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in La Vergne, TN
• Providers in La Vergne, 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 1, 2018; 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.