NPIMap

Organization Active NPI

Princeton Drug

  • Pharmacy
  • Johnson City, TN
National Provider Identifier
1912900663
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
1751 Issued in TN
Legal business name
PRINCETON DRUG
Practice address
105 Broyles Dr
Johnson City, TN 37601-2542
Phone
(423) 282-1178
Fax
(423) 282-0462
NPI assigned
May 24, 2005
Last updated
Nov 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Authorized official

Name
Mr. Mark A ReedNPI 1780784637
Title
Pharmacist
Phone
(423) 282-1178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X 1751 TN Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

105 Broyles Dr
Johnson City, TN 37601-2542

Mailing address

105 Broyles Dr
Johnson City, TN 37601-2542
Phone (423) 282-1178

National Provider Directory

National Provider Directory

Locations

105 Broyles Dr
Johnson City, TN 37601
Phone (423) 282-1178

Practitioners & affiliated clinicians

Practitioners 3

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1912900663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BROYLES DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012542",
            "telephone_number": "423-282-1178",
            "fax_number": "423-282-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BROYLES DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012542",
            "telephone_number": "423-282-1178",
            "fax_number": "423-282-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "423-282-1178",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "1751",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 13, 2015; 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.