Ashley N Tanner I I I

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

000000690 Issued in TN

Legal business name

ASHLEY N TANNER I I I

Doing business as

Baker Drug Store

Practice address

200 W Main St
Jackson, TN 38301-6114

Phone

(731) 427-1528

Fax

(731) 423-4590

NPI assigned

May 5, 2006

Last updated

Jun 17, 2008By 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

Mr. Ashley Tanner IIINPI 1326199357

Title

Pharmacist

Phone

(731) 427-1528

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Baker Drug Store Doing business as

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.

• Ashley N Tanner III, PHARMACIST

  • Pharmacist
  • Jackson, TN
  • NPI 1326199357
  Authorized official Same address or phone

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1629026109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAIN ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383016114",
            "telephone_number": "731-427-1528",
            "fax_number": "731-423-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MAIN ST",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383016114",
            "telephone_number": "731-427-1528",
            "fax_number": "731-423-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY N TANNER I I I",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "731-427-1528",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "000000690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4406977",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3534364",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baker Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Jackson, TN
• Providers in Jackson, 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 Jun 17, 2008; 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.