MEDICAL MALL PHARMACY INC


Address: 105 W Stone Dr, Suite 1-b, Kingsport, TN 37660-3256
Phone: 4232243555

MEDICAL MALL PHARMACY INC (NPI# 1316191349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316191349
Entity Type Organization
Organization Name MEDICAL MALL PHARMACY INC
Other Organization Name STONE DRIVE OUTPATIENT PHARMACY
Practice Address 105 W Stone Dr
Suite 1-b
Kingsport
TN 37660-3256
Practice Telephone 4232243555
Practice Fax Number 4232243560
Enumeration Date 2008-11-04
Last Update Date 2009-02-20
Authorized Official Name CARRIE SWEET (DIRECTOR OF OUTPATIENT PHARMAC)
Authorized Official Telephone 4232308435
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 333600000X Pharmacy 4582 TN Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 4442062 01

Other Provider/Organization Names

Other Name Type Code
Stone Drive Outpatient Pharmacy Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1275536997 Medical Mall Pharmacy Inc Pharmacy 130 W Ravine Rd, Kingsport, TN 37660-3837 2005-05-27
1598768699 Medical Mall Pharmacy Inc Pharmacy 1 Medical Park Blvd, Suite 106-e, Bristol, TN 37620-7430 2005-05-23

Office Location

Street Address 105 W STONE DR
SUITE 1-B
City KINGSPORT
State TN
Zip Code 37660-3256

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659374601 Wendy Tipton Oberdick Family Medicine 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 2005-05-23
1235595919 Everette Barton Nurse Practitioner 105 W Stone Dr, Ste 1j, Kingsport, TN 37660-3365 2016-01-11
1396118618 Amy Galloway Nurse Practitioner 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 2015-11-09
1376928473 Heather Harmon Physical Therapist 105 W Stone Dr, Ste 1d, Kingsport, TN 37660-3365 2015-07-30
1316322753 Christina Danser Nurse Practitioner 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 2015-07-28
1679958995 Wanda King Nurse Practitioner 105 W Stone Dr, Ste 4c, Kingsport, TN 37660-3365 2015-07-28
1538544473 Lindsey Woodlief Nurse Practitioner 105 W Stone Dr, Ste 4c, Kingsport, TN 37660-3365 2015-07-21
1124414289 Abram Arwood Physical Therapist 105 W Stone Dr, Ste 1d, Kingsport, TN 37660-3365 2015-04-15
1700204781 Natasha Kanipe Nurse Practitioner 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 2014-04-07
1396187027 Shane Adam Daniell Physician Assistant 105 W Stone Dr, Ste 3a, Kingsport, TN 37660-3365 2013-07-23
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750909891 Nancy Gober Pharmacist Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 2020-07-06
1700437621 Tammy Denise Leblanc Technician 125 Lancer Rd, Kingsport, TN 37660 2019-09-23
1831743392 Independent Physical Therapy Occupational Therapist 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 2019-08-01
1871095315 Macie Anderson Nurse Practitioner 411 Clay St, Kingsport, TN 37660 2018-03-01
1053813527 Pulitzer Orthodontics, LLC Dentist 1200 Pulitzer Place, Kingsport, TN 37660 2018-03-01
1174038749 Sbh-kingsport Psychiatric Hospital 1025 Executive Park Blvd, Kingsport, TN 37660 2017-12-05
1548771447 Sara B Ball Registered Nurse 111 W Stone Dr Ste 240, Kingsport, TN 37660 2017-10-18
1821525361 Ashley Brook Weems Nurse Practitioner Six Sheridan Square Suite 100, Kingsport, TN 37660 2017-05-15
1639625643 Stephanie H Garris Nurse Practitioner 117 W Sevier Ave Ste 120, Kingsport, TN 37660 2016-08-30
1073965679 Teresa Anne Starke Physician Assistant 8 Sheridan Square, Suite 110, Kingsport, TN 37660 2016-07-07
Find all providers in zip 37660

Taxonomy Information

Taxonomy Code 333600000X
Grouping Suppliers
Classification Pharmacy

Taxonomy Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740809292 Kerri Elizabeth Jones Pharmacy 404 Red Cedar Branch Rd, Kingsport, TN 37664-5049 2020-04-14
1386085132 Premier Pharmacy Inc Pharmacy 109 Jack White Dr, Kingsport, TN 37664-2364 2013-07-09
1447549241 K-va-t Food Stores Inc Pharmacy 300 Clinchfield Street, Kingsport, TN 37660-3604 2011-04-01
1811015928 Cave's Drug Store Inc. Pharmacy 1328 S Jb Dennis Hwy Ste A, Kingsport, TN 37660-5495 2007-03-27
1871610220 City Drug L.l.c Pharmacy 1624 E Stone Dr, Kingsport, TN 37660-4661 2007-03-23
1710093919 Halsey Drug LLC Pharmacy 1901 Brookside Rd, Kingsport, TN 37660-4601 2006-08-21
1780695353 P & S Pharmacy Pharmacy 613 Watauga St, Kingsport, TN 37660-4429 2006-08-10
1881611234 K Va T Food Stores Inc Pharmacy 1205 N Eastman Rd, Crown Point Center, Kingsport, TN 37664-3145 2006-07-15
1437183167 Kroger Limited Partnership I Pharmacy 1664 E Stone Dr, Kingsport, TN 37660-4663 2006-07-10
1386621696 Berrys Pharmacy, Inc. Pharmacy 1717 Fort Henry Dr, Kingsport, TN 37664-3228 2005-12-28
Find all providers in KINGSPORT

Competitor

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City KINGSPORT
Zip Code 37660

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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