Organization Active NPI

Rocky Top Pharmacy of Loudon Inc.

Doing business as Rocky Top Health Services

  • Internal Medicine Physician
  • Loudon, TN
National Provider Identifier
1649649849
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROCKY TOP PHARMACY OF LOUDON INC.
Doing business as
Rocky Top Health Services
Practice address
702 Grove St
Loudon, TN 37774-1481
Phone
(865) 657-3500
Fax
(865) 657-3502
NPI assigned
Sep 17, 2015
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Charlie David Coscia, PHARMDNPI 1871625376
Title
Owner/Authorized Official
Phone
(865) 657-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Internal Medicine Physician 207R00000X Primary
Community/Retail Pharmacy 3336C0003X 5658 TN

Addresses

Primary practice location

702 Grove St
Loudon, TN 37774-1481

Mailing address

106 Administration Rd
Oak Ridge, TN 37830-6954
Phone (865) 566-1909

Other names 1

  • Rocky Top Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20160830002110 TN Part B Supplier - Pharmacy 0749574135 Practice locations: Loudon, TN
O20161228000828 TN DME Supplier - Pharmacy 0749574135 Practice locations: Loudon, TN
O20221005001307 TN Part B Supplier - Clinic/Group Practice 0749574135 Receives reassigned benefits from 1 practitioner
Practice locations: Loudon, TN

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rocky Top Pharmacy of Loudon Inc.702 Grove St, Loudon, TN 37774-1481(865) 657-3500 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since May 20, 2016

National Provider Directory

National Provider Directory

Locations

702 Grove St
Loudon, TN 37774
Phone (865) 458-9080

702 Grove St
Ste 202
Loudon, TN 37774
Phone (865) 458-7910

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1649649849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 ADMINISTRATION RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306954",
            "telephone_number": "865-566-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 GROVE ST",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741481",
            "telephone_number": "865-657-3500",
            "fax_number": "865-657-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY TOP PHARMACY OF LOUDON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "COSCIA",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "865-657-3500",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "5658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Top Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loudon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.