NPIMap

Organization Active NPI

Galen Pharmacy, LLC

  • Community/Retail Pharmacy
  • Hixson, TN
National Provider Identifier
1851921530
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GALEN PHARMACY, LLC
Practice address
4972 Alpha Lane
Hixson, TN 37343
Phone
(423) 497-5360
Fax
(423) 305-7269
NPI assigned
Jan 22, 2020
Last updated
May 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Misty Hickman
Title
Chief Informatics Officer
Phone
(423) 308-0280

Specialties & licenses 1

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

Addresses

Primary practice location

4972 Alpha Lane
Hixson, TN 37343

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

Other identifiers 1

IdentifierTypeStateIssuer
Q057693MedicaidTN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200813000108 TN Part B Supplier - Pharmacy 5496179772 Practice locations: Hixson, TN
O20201223001715 TN Part B Supplier - Mass Immunization (Roster Biller Only) 5496179772 Practice locations: Hixson, TN

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4972 Alpha Ln
Hixson, TN 37343
Phone (423) 497-5360

Practitioners & affiliated clinicians

Practitioners 12

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": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1851921530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 ALPHA LANE",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "37343",
            "telephone_number": "423-497-5360",
            "fax_number": "423-305-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALEN PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "CHIEF INFORMATICS OFFICER",
        "authorized_official_telephone_number": "423-308-0280"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q057693",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.