NPIMap

Organization Active NPI

George E Hooten & Robert K Galloway III PTR Manor Pharmacy

  • Community/Retail Pharmacy
  • Hermitage, TN
National Provider Identifier
1922182294
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
276 Issued in TN
Legal business name
GEORGE E HOOTEN & ROBERT K GALLOWAY III PTR MANOR PHARMACY
Practice address
4343 Lebanon Pike
Suite 100
Hermitage, TN 37076-1221
Phone
(615) 883-5522
Fax
(615) 885-0402
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Mr. George Edward Hooten, DPH
Title
Pharmacist - Owner
Phone
(615) 883-5522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 276 TN Primary

Addresses

Primary practice location

4343 Lebanon Pike
Suite 100
Hermitage, TN 37076-1221

Mailing address

4343 Lebanon Pike
Suite 100
Hermitage, TN 37076-1221
Phone (615) 883-5522

Other identifiers 1

IdentifierTypeStateIssuer
68401MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Georg E Hooton Robert K Galloway III PTR Manor Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1922182294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 LEBANON PIKE",
            "address_2": "SUITE 100",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761221",
            "telephone_number": "615-883-5522",
            "fax_number": "615-885-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 LEBANON PIKE",
            "address_2": "SUITE 100",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761221",
            "telephone_number": "615-883-5522",
            "fax_number": "615-885-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE E HOOTEN & ROBERT K GALLOWAY III PTR MANOR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "HOOTEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHARMACIST - OWNER",
        "authorized_official_telephone_number": "615-883-5522",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68401",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.