Active NPI
Pharmacy Home Care of East Tennessee, Inc
- Long Term Care Pharmacy
- Cleveland, TN
National Provider Identifier
1710220918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- PHARMACY HOME CARE OF EAST TENNESSEE, INC
- Practice address
- 120 23Rd St NW
Cleveland, TN 37311-3845 - Phone
- (423) 790-1221
- NPI assigned
- Apr 5, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffry H Wolfenden, RPH
- Title
- President
- Phone
- (423) 790-7336
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | TN | Primary |
Addresses
Primary practice location
120 23Rd St NW
Cleveland, TN 37311-3845
Mailing address
PO Box 2607
Cleveland, TN 37320-2607
Phone (423) 790-7336
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q032865 | Medicaid | TN | |
| 4445854 | Other | TN | NABP |
| 5186 | Other | TN | STATE LICENSE BOARD OF PHARMACY |
Other names 1
- Pharmacy Home Care of East Tennessee
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160318000979 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 1153628193 | Practice locations: Cleveland, TN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2216834 | Pharmacy Home Care of East Tennessee | Certificate of waiver | Mar 15, 2027 |
National Provider Directory
National Provider DirectoryLocations
120 23rd St NW
Cleveland, TN 37311
Phone (423) 472-6482
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Athens, TN
- NPI 1942714688
-
- Pharmacist
- Chattanooga, TN
- NPI 1932760014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785196800000",
"number": "1710220918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2607",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373202607",
"telephone_number": "423-790-7336",
"fax_number": "423-790-7338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 23RD ST NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373113845",
"telephone_number": "423-790-1221"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHARMACY HOME CARE OF EAST TENNESSEE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-05",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A",
"authorized_official_last_name": "WOLFENDEN",
"authorized_official_first_name": "JEFFRY",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "423-790-7336",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q032865",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "4445854",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE BOARD OF PHARMACY",
"identifier": "5186",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pharmacy Home Care of East Tennessee",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.