NT Medical Center Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

446 Issued in TN

Legal business name

NT MEDICAL CENTER PHARMACY, LLC

Doing business as

Medical Center Pharmacy

Practice address

606 N Broad St
New Tazewell, TN 37825-6610

Phone

(423) 626-5411

Fax

(423) 626-6538

NPI assigned

Nov 8, 2006

Last updated

May 16, 2016By 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

Adam E Bowling

Title

Owner/Member

Phone

(423) 626-5411

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Medical Center Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derek Verldon Hicks, PHARM D

  • Pharmacist
  • New Tazewell, TN
  • NPI 1467555094
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1487723789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1649",
            "city": "NEW TAZEWELL",
            "state": "TN",
            "postal_code": "378241649",
            "telephone_number": "423-626-5411",
            "fax_number": "423-626-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N BROAD ST",
            "city": "NEW TAZEWELL",
            "state": "TN",
            "postal_code": "378256610",
            "telephone_number": "423-626-5411",
            "fax_number": "423-626-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NT MEDICAL CENTER PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "423-626-5411"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": "6090070001",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "446",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "TN",
            "license": "446",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4410572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Max L Money, FNP
• Melissa Brooks Morelock, RN
• Brent Sheldon Neal, MD
• Holly Nicely, R.N.
• Emma Maecyn Nolan
• Linda Sue Osborne, RN
• Kelli Padgett, PT
• Erica J Palmer, OTR
• Luis C Pannocchia, M.D.
• Ellen Cawood Partin, FNP-BC

• Community/Retail Pharmacy in New Tazewell, TN
• Providers in New Tazewell, 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 May 16, 2016; 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.