Mosheim Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2926 Issued in TN

Legal business name

MOSHEIM PHARMACY INC

Doing business as

Mosheim Pharmacy

Practice address

6766 W Johnson Hwy
Mosheim, TN 37818

Phone

(423) 422-9099

Fax

(423) 422-9760

NPI assigned

Oct 26, 2006

Last updated

Feb 15, 2012By 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

Charles Susong, PHRMD

Title

President

Phone

(423) 639-8631

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MOSHEIM PHARMACY Doing business as

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1710062948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "MOSHEIM",
            "state": "TN",
            "postal_code": "378180100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6766 W JOHNSON HWY",
            "city": "MOSHEIM",
            "state": "TN",
            "postal_code": "37818",
            "telephone_number": "423-422-9099",
            "fax_number": "423-422-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHEIM PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "SUSONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-639-8631",
        "authorized_official_credential": "PHRMD"
    },
    "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": "2926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4428163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOSHEIM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandon Aaron Clum
• Eric Wesley Jones, LAT, ATC
• Catherine N Lowe
• Candice Gail Moore, MA, LPC
• Mosheim Drug, LLC (The Medicine Shoppe #1994)
• Mosheim Recovery Associates
• Mosheim Recovery Associates Inc
• Mountain Visions Inc
• Keith Pratt, MD
• Betty Jean Wells, OTR

• Community/Retail Pharmacy in Mosheim, TN
• Providers in Mosheim, 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 Feb 15, 2012; 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.