Tucker Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

TUCKER PHARMACY, LLC

Practice address

2415 Fairview Blvd
Fairview, TN 37062-9078

Phone

(615) 799-0691

NPI assigned

Nov 16, 2019

Organization subpart

No

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

Authorized official

Name

Jimmy Tucker

Title

Ceo

Phone

(601) 946-1826

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681603200000",
    "number": "1639714397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10394 TIDWELL RD",
            "city": "BON AQUA",
            "state": "TN",
            "postal_code": "370251567",
            "telephone_number": "601-946-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 FAIRVIEW BLVD",
            "city": "FAIRVIEW",
            "state": "TN",
            "postal_code": "370629078",
            "telephone_number": "615-799-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCKER PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-16",
        "last_updated": "2023-04-16",
        "certification_date": "2023-04-16",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-946-1826"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Danielle Thayer, FNP-C
• The Pearl at Fairview, LLC
• Kristina D Thornberry, NP-C
• Tabitha Marie Tidwell, PHARM D
• Tree of Life Medical and Counseling Center
• Morgan Tucker, PHARMD
• Joseph Thomas Valletti, LMFT
• Vibe Dental of Fairview
• Wal-Mart Stores East LP
• Joseph Welch, M.DIV., MMFT

• Community/Retail Pharmacy in Fairview, TN
• Providers in Fairview, 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 Apr 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.