SC Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Spring City, TN
NPI 1821645201 · NPPES record last updated Sep 28, 2023
Key facts
- NPI
- 1821645201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- SC PHARMACY LLC
- Practice address
- 171 Clinton Ave
Spring City, TN 37381-4037 - Phone
- (423) 365-6351
- Fax
- (423) 365-4877
- NPI assigned
- Aug 21, 2019
- Organization subpart
- No
Authorized official
- Name
- Jonathan Seth Zimmerman, PHARMD
- Title
- Owner/Pharmacist
- Phone
- (423) 365-6351
Practitioners 2
-
Jonathan Seth Zimmerman, PHARMD
-
Jessica Renee Gunther, PHARMD
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| SC Pharmacy LLC |
Nebulizer Drugs | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200212001319 | TN | DME Supplier - Pharmacy | 8921434853 | Practice locations: Spring City, TN |
| O20200505001272 | TN | Part B Supplier - Pharmacy | 8921434853 | Practice locations: Spring City, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
171 Clinton Ave
Spring City, TN 37381-4037
Mailing address
PO Box 515
Spring City, TN 37381-0515
Phone (423) 365-6351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q051561 | Medicaid | TN |
Other names
- Spring City Pharmacy
Other providers in Spring City, TN
- Rhea Medical Center
- Rhea Medical Center
- Rhea Medical Center
- Rhonda Gross
- Clark Christopher Rose
- Alexis Smith
- Frank Stephen Snyder
- Estel Ray Sparks
- Hannah Spencer
- Spring City Family Clinic PLLC
All providers in Spring City, TN · Community/Retail Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.