BLACK BEAR PHARMACY, INC. (NPI# 1538663281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538663281 |
| Entity Type | Organization |
| Organization Name | BLACK BEAR PHARMACY, INC. |
| Other Organization Name | PHD PHARMACY LTC |
| Practice Address |
110 Keith St Sw Ste 1and2 Cleveland TN 37311-5868 |
| Mailing Address |
Po Box 580 Mcdonough GA 30253-0580 |
| Practice Telephone | 4236146650 |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2020-02-03 |
| Authorized Official Name | LOREN PIERCE (OWNER) |
| Authorized Official Telephone | 7704747693 |
| Is Organization Subpart | Y |
| Parent Organization Name | BLACK BEAR PHARMACY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| PHD Pharmacy LTC | Doing Business As Name - Organization |
| PHD Pharmacy MO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487211058 | Black Bear Pharmacy, Inc. | Pharmacy | 110 Keith St Sw Ste 1&2, Cleveland, TN 37311-5868 | 2019-05-20 |
| 1215444344 | Black Bear Pharmacy, Inc. | Pharmacy | 110 Keith St Sw, Ste 1&2, Cleveland, TN 37311 | 2018-01-10 |
| Street Address |
110 KEITH ST SW STE 1AND2 |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37311-5868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114433570 | Kirstee Williams | Counselor | 1120 North Ocoee Street, Lee University, Cleveland, TN 37311 | 2017-12-21 |
| 1285070458 | Scott Daniel Pugh | Counselor | 183 1st St Ne, Cleveland, TN 37311 | 2013-05-15 |
| 1407299191 | Bess E Howard | Nurse Practitioner | 2449 Spring Creek Blvd, Ne, Cleveland, TN 37311 | 2013-04-11 |
| 1588913925 | Thomas C Reese | Hearing Instrument Specialist | 60 25th Street Ne, Suite 5, Cleveland, TN 37311 | 2012-08-30 |
| 1932484607 | Southeast Tn Human Resource Agency | Non-emergency Medical Transport (VAN) | 165 Edwards Street Se, Cleveland, TN 37311 | 2011-10-13 |
| 1588956106 | Lee M Radford | Orthopaedic Surgery | 2350 N Ocoee Street, Cleveland, TN 37311 | 2011-05-16 |
| 1124251913 | Mcfarland Group Inc. | Durable Medical Equipment & Medical Supplies | 1300 25th St Nw # 104, Cleveland, TN 37311 | 2009-08-27 |
| 1952554834 | Bradley Cleveland Services Inc | Counselor | 2611 Bower Lane, Cleveland, TN 37311 | 2008-10-23 |
| 1851543151 | Bradley Cleveland Services, Inc | Counselor | 2601 Bower Lane Se, Cleveland, TN 37311 | 2008-10-17 |
| 1306098082 | Kidney Center of Cleveland, LLC | Clinic/Center | 2253 Chambliss Avenue, Cleveland, TN 37311 | 2008-10-14 |
| Find all providers in zip 37311 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083644090 | Omnicare Pharmacy of Tennessee, LLC | Pharmacy | 145 Industrial Way Sw, Cleveland, TN 37311-7114 | 2006-07-04 |
| 1689611493 | Cleveland Worx LLC | Pharmacy | 1690 25th St Nw Suite A, Cleveland, TN 37311 | 2006-06-01 |
| 1972153708 | Cooke Food Store Inc | Pharmacy | 3400 Keith Street, Cleveland, TN 37312 | 2019-09-13 |
| 1609273630 | Ltc Pharmacy Services LLC | Pharmacy | 3915 Adkisson Dr Nw, Cleveland, TN 37312-2821 | 2014-11-19 |
| 1710220918 | Pharmacy Home Care of East Tennessee, Inc | Pharmacy | 120 23rd St Nw, Cleveland, TN 37311-3845 | 2013-04-05 |
| 1598775181 | Forshee/carder Pharmacies, Inc. | Pharmacy | 2850 Westside Dr Nw, Suite E, Cleveland, TN 37312-3503 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199432 | Boones Creek Pharmacy, Inc. | Pharmacy | 4729 N Roan St Ste 2, Johnson City, TN 37615-3886 | 2020-09-18 |
| 1164032546 | Polaris Pharmacy Services of Tennessee, LLC | Pharmacy | 7005 Wesbelt Drive, Nashville, TN 32709 | 2020-07-31 |
| 1386261030 | Jeffrey Allan Anderson | Pharmacy | 721 N Tennessee Ave, Etowah, TN 37331-1754 | 2020-06-29 |
| 1376171652 | Boatwright Drug Co., Inc | Pharmacy | 7899 Leroy Boatwright St, Millington, TN 38053-2137 | 2020-03-31 |
| 1245868850 | Seymour Pharmacy Inc. | Pharmacy | 10721 Chapman Hwy Ste 6, Seymour, TN 37865-4771 | 2020-03-30 |
| 1700423654 | Southland Ltc Pharmacy | Pharmacy | 482 Interstate Dr Ste L, Manchester, TN 37355-3485 | 2019-12-10 |
| 1104380930 | Fannon Drug Co. | Pharmacy | 606 E. Emory Rd, Powell, TN 37849 | 2019-01-25 |
| 1891231734 | Rams Pharmacy LLC | Pharmacy | 1210 Hazelwood Dr Ste D, Smyrna, TN 37167-3964 | 2017-01-17 |
| 1982056529 | Pharmblue Tennessee LLC | Pharmacy | 1113 Murfreesboro Rd Ste 319-b, Franklin, TN 37064-1306 | 2016-07-07 |
| 1043685852 | Rams Pharmacy LLC | Pharmacy | 412 Gallatin Pike N, Madison, TN 37115-3706 | 2015-12-04 |
| Find all providers with the same taxonomy | ||||
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| 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.