NPIMap

Organization Active NPI

Northeast Tennessee Dispensary of Hope Pharmacy

  • Community/Retail Pharmacy
  • Johnson City, TN
National Provider Identifier
1770878969
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
04640 Issued in TN
Legal business name
NORTHEAST TENNESSEE DISPENSARY OF HOPE PHARMACY
Practice address
401A Elm St
Johnson City, TN 37601-4601
Phone
(423) 431-1570
NPI assigned
Jun 15, 2011
Last updated
Jun 15, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNTAIN STATE HEALTH ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Dr. Joy Waddell, PHARM-D
Title
Pharmacy Site Manager/Pic
Phone
(423) 431-1570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 04640 TN Primary

Addresses

Primary practice location

401A Elm St
Johnson City, TN 37601-4601

Mailing address

401A Elm St
Johnson City, TN 37601-4601
Phone (423) 431-1570

National Provider Directory

National Provider Directory
Tax ID family
Mountain States Health Alliance41 organizations share this tax ID, including this one
Part of
Mountain States Health Alliance

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Locations

401A Elm St
Johnson City, TN 37601
Phone (423) 431-1570

Practitioners & affiliated clinicians

Practitioners 1

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": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1770878969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401A ELM ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014601",
            "telephone_number": "423-431-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401A ELM ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014601",
            "telephone_number": "423-431-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST TENNESSEE DISPENSARY OF HOPE PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAIN STATE HEALTH ALLIANCE",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "PHARMACY SITE MANAGER/PIC",
        "authorized_official_telephone_number": "423-431-1570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM-D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "04640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.