Watertown Drugs, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4653 Issued in TN

Legal business name

WATERTOWN DRUGS, INC

Doing business as

Watertown Drugs

Practice address

406 Public SQ
Watertown, TN 37184-1421

Phone

(615) 237-0054

Fax

(615) 237-0016

NPI assigned

Jun 3, 2009

Last updated

Dec 2, 2020By 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

Candace S Mathis, DPHNPI 1578174272

Title

Owner

Phone

(615) 237-0054

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Watertown Drugs Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

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.

• Candace S Mathis, DPH

  • Pharmacist
  • Lascassas, TN
  • NPI 1578174272
  NPD Authorized official
• Zachary Stephen Ayers, PHARMD

  • Pharmacist
  • Watertown, TN
  • NPI 1770174575
  NPD

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1669608733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 PUBLIC SQ",
            "city": "WATERTOWN",
            "state": "TN",
            "postal_code": "371841421",
            "telephone_number": "615-237-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 PUBLIC SQ",
            "city": "WATERTOWN",
            "state": "TN",
            "postal_code": "371841421",
            "telephone_number": "615-237-0054",
            "fax_number": "615-237-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN DRUGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-237-0054",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "4653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120449",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q035515",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watertown Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel McRoberts, LPC-MHSP, NCC, RPT-S
• Calicia Jean Moss
• Carl Newton, ATC
• Erin Brooke Owens, MS, CCC-SLP
• Therapy Abode LLC
• Lorelei Grace Wetherell

• Community/Retail Pharmacy in Watertown, TN
• Providers in Watertown, 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 Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.