Active NPI
Cameron Tyler Hargrove, PHARMD
- Pharmacist
- Bolivar, TN
National Provider Identifier
1568070217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 44410
- Practice address
- 1604 W Market St
Bolivar, TN 38008-1536 - Phone
- (731) 658-7181
- NPI assigned
- Jul 20, 2020
- Last updated
- Jul 20, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 44410 | TN | Primary |
Addresses
Primary practice location
1604 W Market St
Bolivar, TN 38008-1536
Mailing address
17 Nehemiah Dr
Jackson, TN 38305-1898
Phone (931) 334-5955
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | cthargr.s00466@US.wal-mart.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Walmart Pharmacy 10-0466
- Community/Retail Pharmacy
- Bolivar, TN
- NPI 1881611069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1568070217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 NEHEMIAH DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383051898",
"telephone_number": "931-334-5955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 W MARKET ST",
"city": "BOLIVAR",
"state": "TN",
"postal_code": "380081536",
"telephone_number": "731-658-7181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARGROVE",
"first_name": "CAMERON",
"middle_name": "TYLER",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-20",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "44410",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "cthargr.s00466@US.wal-mart.com",
"affiliation": "N",
"address_1": "1604 W Market St",
"city": "Bolivar",
"state": "TN",
"country_code": "US",
"postal_code": "380081536",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bolivar, TN
- Hardeman County Community Health Center
- Hardeman County Community Health Center
- Hardeman County Community Health Center (HCCHC Women & Children's Center)
- Hardeman County Schools
- Hardeman County Vision Center Inc
- Hatchie Clinic P C
- Angela Dawn Haynes, RN
- Hcchc Pharmacy
- Ollie Herron, FNP-C, PMHNP-BC
- Sandi Hines
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.