Jack W Greene, Dba

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1122 Issued in TN

Legal business name

JACK W GREENE, DBA

Doing business as

JEFFERSON COMPOUNDING CENTER

Practice address

22 N Jefferson Cir
Oak Ridge, TN 37830-4805

Phone

(865) 483-3007

Fax

(865) 483-3071

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jack W Greene, D.PH.

Title

Owner-Pharmacist

Phone

(865) 483-3007

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• JEFFERSON COMPOUNDING CENTER Doing business as

Locations

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1619195351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N JEFFERSON CIR",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378304805",
            "telephone_number": "865-483-3007",
            "fax_number": "865-483-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N JEFFERSON CIR",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378304805",
            "telephone_number": "865-483-3007",
            "fax_number": "865-483-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK W GREENE, DBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER-PHARMACIST",
        "authorized_official_telephone_number": "865-483-3007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "1122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST OF TN BOARD OF PHARMAC",
            "identifier": "1122",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4410673",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEFFERSON COMPOUNDING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harber Ingle, CRNA
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• Katherine J Irwin, MS, RD, LDN, CNSC
• Michael Lee Irwin, PT
• Richmond Keith Ivens, PHARMD
• Janet Elaine Jack, SLP
• Christy Wiest Jackson
• Jackson Jacobik, PT
• Brett J Jaffrey, DDS
• Amy Marie James, ANP

• Community/Retail Pharmacy in Oak Ridge, TN
• Providers in Oak Ridge, 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 Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.