Organization Active NPI

Hillcrest Drug Store Inc

  • Community/Retail Pharmacy
  • Johnson City, TN
National Provider Identifier
1902811557
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0477 Issued in TN
Legal business name
HILLCREST DRUG STORE INC
Practice address
714 W Market St Ste 103
Johnson City, TN 37604-5483
Phone
(423) 926-6231
Fax
(423) 926-0084
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Authorized official

Name
Doug Austin
Title
Pic
Phone
(423) 926-0084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 0477 TN Primary

Addresses

Primary practice location

714 W Market St Ste 103
Johnson City, TN 37604-5483

Mailing address

714 W Market St Ste 103
Johnson City, TN 37604-5483
Phone (423) 926-6231

Other identifiers 2

IdentifierTypeStateIssuer
3551938MedicaidTN
2095599OtherPK

Other names 1

  • HILLCREST DRUG STORE Doing business as

National Provider Directory

National Provider Directory

Locations

714 W Market St
Ste 103
Johnson City, TN 37604
Phone (423) 926-2422

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1902811557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W MARKET ST STE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045483",
            "telephone_number": "423-926-6231",
            "fax_number": "423-926-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W MARKET ST STE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045483",
            "telephone_number": "423-926-6231",
            "fax_number": "423-926-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "423-926-0084"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "0477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3551938",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2095599",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HILLCREST DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.