Medi Mart Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

0000000354 Issued in TN

Legal business name

MEDI MART PHARMACY

Practice address

5030 Georgetown Rd NW
Cleveland, TN 37312-1309

Phone

(423) 472-5548

Fax

(423) 472-6400

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Joe Moore

Title

Owner

Phone

(423) 476-7947

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1861407496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3240",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373203240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 GEORGETOWN RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121309",
            "telephone_number": "423-472-5548",
            "fax_number": "423-472-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI MART PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-476-7947"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000354",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "0000000354",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4439255",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claire Chisolm McNeiland, PT
• Angela Free McPherson, D.C.
• April McRoberts, RN
• Med-Trans Corporation
• Linda Kathryn Medford, RN, WHNP-C
• Medical Center Pharmacy Inc
• Medical Center Pharmacy Inc
• Medical Center Pharmacy Inc
• Keith Bernard Medley, PHARMD
• Medstride PLLC

• Pharmacy in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.