Good Old Drugstore Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4193 Issued in TN

Legal business name

GOOD OLD DRUGSTORE INC

Practice address

8295 Highway 131
Washburn, TN 37888

Phone

(865) 497-9999

Fax

(865) 497-9990

NPI assigned

Sep 19, 2005

Organization subpart

No

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

Authorized official

Name

David Malone

Title

Pic

Phone

(865) 497-9999

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1790770519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "WASHBURN",
            "state": "TN",
            "postal_code": "378880098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8295 HIGHWAY 131",
            "city": "WASHBURN",
            "state": "TN",
            "postal_code": "37888",
            "telephone_number": "865-497-9999",
            "fax_number": "865-497-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD OLD DRUGSTORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "865-497-9999"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "4193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4438443",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrystal Byrd, PA
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• Community/Retail Pharmacy in Washburn, TN
• Providers in Washburn, 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 Sep 14, 2007; 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.