Personal Pharmacy Care LLC
Organization Active NPI Long Term Care Pharmacy · Counce, TN
NPI 1992032288 · NPPES record last updated Jan 10, 2020
Key facts
- NPI
- 1992032288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- License
- 113361 (AL)
- Legal business name
- PERSONAL PHARMACY CARE LLC
- Practice address
- 11272 Highway 57
Counce, TN 38326-3802 - Phone
- (731) 689-0223
- Fax
- (731) 689-0253
- NPI assigned
- Nov 8, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. John Casey Austin, PHARM D
- Title
- Director of Pharmacy
- Phone
- (731) 610-8273
Practitioners 3
-
John Casey Austin, PHARM.D
-
Ruth B Lambert, DPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120228000444 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 3173795945 | Practice locations: Counce, TN |
National Provider Directory
Locations
11272 Highway 57
Counce, TN 38326
Phone (731) 689-0223
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 08368/7.1 | MS | |
| Long Term Care Pharmacy | 3336L0003X | 4706 | TN | |
| Long Term Care Pharmacy | 3336L0003X | 113361 | AL | Yes |
Addresses
Primary practice location
11272 Highway 57
Counce, TN 38326-3802
Mailing address
11272 Highway 57
Counce, TN 38326-3802
Phone (731) 689-0223
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118443 | Medicaid | AL | |
| 1992032288 | Medicaid | TN | |
| 52757579 | Medicaid | CO | |
| 04326518 | Medicaid | MS | |
| 2122728 | Other | PK |
Other names
- PPC-Rx
Other providers in Counce, TN
- Kimberly Brasseal Labas
- Ruth B Lambert
- Krystal Lasha Long
- Amy B Mitchell
- Tisha Winningham Perkins
- Joseph A Peters
- Pickwick Family Dentalk Care , Inc.
- Pickwick Pharmacy, PLLC
- Diane Renee Wendt
- Abbey A Williams
All providers in Counce, TN · Long Term Care Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.