NPIMap

Organization Active NPI

Community Pharmacy Care, Inc

  • Community/Retail Pharmacy
  • Dickson, TN
National Provider Identifier
1518153972
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
324 Issued in TN
Legal business name
COMMUNITY PHARMACY CARE, INC
Doing business as
Goodlark Pharmacy
Practice address
111 Hwy 70 E
Dickson, TN 37055-2080
Phone
(615) 446-8043
NPI assigned
Sep 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Authorized official

Name
Martha Shepard, DPH
Title
Owner/ Pharmacist
Phone
(615) 446-8043

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 324 TN
Community/Retail Pharmacy 3336C0003X 324 TN Primary

Addresses

Primary practice location

111 Hwy 70 E
Dickson, TN 37055-2080

Mailing address

111 Hwy 70 E
Dickson, TN 37055-2080
Phone (615) 446-8043

Other names 1

  • Goodlark Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070921000729 TN Part B Supplier - Mass Immunization (Roster Biller Only) 3577657410 Practice locations: Dickson, TN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Dickson Apothecary5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1518153972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HWY 70 E",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552080",
            "telephone_number": "615-446-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HWY 70 E",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552080",
            "telephone_number": "615-446-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "OWNER/ PHARMACIST",
        "authorized_official_telephone_number": "615-446-8043",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "324",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodlark Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.