Del Mar Medical, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

2078 Issued in TN

Legal business name

DEL MAR MEDICAL, INC.

Doing business as

Del Mar Medical

Practice address

198 E Division St
Mt Juliet, TN 37122-3324

Phone

(615) 754-4667

Fax

(615) 754-2582

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mickey Jackson

Title

Owner/President

Phone

(615) 754-4667

Specialties & licenses 3

Addresses

Other names 1

• Del Mar Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alison Cragwall, PHARMD

  • Pharmacist
  • Mount Juliet, TN
  • NPI 1598429185
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1861404139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371210787",
            "telephone_number": "615-754-4667",
            "fax_number": "615-758-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E DIVISION ST",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371223324",
            "telephone_number": "615-754-4667",
            "fax_number": "615-754-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEL MAR MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "615-754-4667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "TN",
            "license": "2078",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "2078",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "TN",
            "license": "2078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del Mar Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Skylar Day
• Daybreak Therapy, LLC
• Lora Ann Deckard-Smart, APRN
• Cory E Declue, MD
• Rachel Jones Deffendall, FNP-BC
• Demeka Campbell-MD
• Kenneth A Demirjian, M.D.
• Denise Senior Living
• Christopher Ryan Dennis
• Gregory Scott Denton, D.D.S.

• Long Term Care Pharmacy in Mt Juliet, TN
• Providers in Mt Juliet, TN by specialty
• Long Term Care Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.