Organization Active NPI

Med RX Pharmacy PC

Doing business as Preeminent Health & Wellness

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1760838528
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MED RX PHARMACY PC
Doing business as
Preeminent Health & Wellness
Practice address
1356 Union University Dr
Ste G
Jackson, TN 38305
Phone
(731) 300-7311
Fax
(731) 300-7319
NPI assigned
May 11, 2016
Last updated
Aug 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Authorized official

Name
Brad MedlingNPI 1710311717
Title
Ceo
Phone
(731) 693-7351

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Pharmacy 333600000X 5793 TN
Pharmacy 333600000X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

1356 Union University Dr
Ste G
Jackson, TN 38305

Mailing address

1356 Union University Dr
Ste G
Jackson, TN 38305
Phone (731) 300-7311

Other identifiers 1

IdentifierTypeStateIssuer
2160091OtherPK

Other names 1

  • Preeminent Health & Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161104000572 TN Part B Supplier - Mass Immunization (Roster Biller Only) 6800174301 Practice locations: Greenfield, TN
O20210624002322 TN Part B Supplier - Clinic/Group Practice 5698176956 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory

Locations

108 S Front St
Greenfield, TN 38230
Phone (731) 678-0201

1356 Union University Dr
Ste G
Jackson, TN 38305
Phone (731) 300-7311

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1760838528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 UNION UNIVERSITY DR",
            "address_2": "STE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-300-7311",
            "fax_number": "731-300-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 UNION UNIVERSITY DR",
            "address_2": "STE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-300-7311",
            "fax_number": "731-300-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED RX PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "MEDLING",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "731-693-7351"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "5793",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160091",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preeminent Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Preeminent Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.