MOUNTAIN HOME VAMC (NPI# 1548218266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548218266 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN HOME VAMC |
| Other Organization Name | MOUNTAIN HOME VAMC PHARMACY |
| Practice Address |
1141 Cold Springs Rd Mountain City TN 37683-4032 |
| Mailing Address |
Po Box 94516 Cleveland OH 44101 |
| Practice Telephone | 4239793434 |
| Practice Fax Number | 4239793019 |
| Mailing Telephone | 6153553451 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332100000X | Department of Veterans Affairs (VA) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | NCPDP# | 4436540 | 01 |
| Other Name | Type Code |
|---|---|
| MOUNTAIN HOME VAMC PHARMACY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922544394 | Mountain Home Vamc | Clinic/Center | 1521 Downtown West Blvd, Knoxville, TN 37919-5407 | 2017-01-10 |
| 1316335680 | Mountain Home Vamc | Clinic/Center | 32613 Wilderness Road, Suite 101, Jonesville, VA 24263-9998 | 2015-01-08 |
| 1497143531 | Mountain Home Vamc | Clinic/Center | 4451 Lee Highway, Marion, VA 24354-9998 | 2014-12-23 |
| 1306234448 | Mountain Home Vamc | Clinic/Center | 1941 Lover's Gap Lane, Suite A, Vansant, VA 24656-9998 | 2014-12-23 |
| 1639342231 | Mountain Home Vamc | Clinic/Center | 925 E Morris Blvd, Morristown, TN 37813-2499 | 2008-04-04 |
| 1700824646 | Mountain Home Vamc | Clinic/Center | 401 Scenic Dr, Rogersville, TN 37857-2452 | 2006-06-03 |
| 1841237385 | Mountain Home Vamc | Clinic/Center | 654 Highway 58 E, Norton, VA 24273-3002 | 2006-06-01 |
| 1831148253 | Mountain Home Vamc | General Acute Care Hospital | Sidney and Lamont Streets, Mountain Home, TN 37684-4000 | 2006-05-10 |
| 1982236907 | Mountain Home Vamc | Clinic/Center | 500 Washington Ave, Johnson City, TN 37604-5518 | 2020-02-07 |
| 1053942474 | Mountain Home Vamc | Clinic/Center | 1141 Cold Springs Rd, Mountain City, TN 37683-4032 | 2020-02-04 |
| Street Address |
1141 COLD SPRINGS RD |
| City | MOUNTAIN CITY |
| State | TN |
| Zip Code | 37683-4032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053942474 | Mountain Home Vamc | Clinic/Center | 1141 Cold Springs Rd, Mountain City, TN 37683-4032 | 2020-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245749126 | Sugaree Ganzman | Registered Nurse | 277 Trout Run Rd, Mountain City, TN 37683 | 2017-09-24 |
| 1013390764 | Emily B. Mcqueen | Nurse Practitioner | 1901 South Shady Street, Mountain City, TN 37683 | 2015-06-30 |
| 1972917755 | Kelly Horne Singleton | Nurse Practitioner | 3916 Hwy 421 South, Mountain City, TN 37683 | 2014-06-19 |
| 1548496557 | Michelle Wilson | Nurse Practitioner | 1901 S. Shady Street, Mountain City, TN 37683 | 2009-06-04 |
| 1710025069 | Sheila Annette Porter | Counselor | 318 Donnelly Street, Mtn City, TN 37683 | 2007-02-01 |
| 1619050390 | Brandy Lynn Bennett | Case Manager/Care Coordinator | 318 Donnelley Street, Johnson Co Counsel Cent, Mtn City, TN 37683 | 2006-10-24 |
| 1811086317 | Robb R Miller | Counselor | 318 Donnelley St, Johnson County Counseling Center, Mountain City, TN 37683 | 2006-10-12 |
| 1700834678 | Margaret Grace Steward | Pharmacist | 1641 South Shady St, Mountain City, TN 37683 | 2006-05-04 |
| 1184169658 | Wanda Jarrett | Nurse Practitioner | 1901 S Shady St, Mountain City, TN 37683 | 2016-12-20 |
| 1558797399 | Mollie E Tolan | Nurse Practitioner | 1901 S. Shady Street, Johnson City, TN 37683 | 2013-09-25 |
| Find all providers in zip 37683 | ||||
| Taxonomy Code | 332100000X |
| Grouping | Suppliers |
| Classification | Department of Veterans Affairs (VA) Pharmacy |
| Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service. |
| Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144271776 | Nashville Vamc | Department of Veterans Affairs (VA) Pharmacy | 6098 Debra Rd Ste 5200, Chattanooga, TN 37411-5702 | 2006-05-16 |
| 1689622458 | Murfreesboro Va Cmop | Department of Veterans Affairs (VA) Pharmacy | 5171 Sam Jared Dr, Murfreesboro, TN 37130-1382 | 2006-05-04 |
| 1275750192 | Va Medical Center Memphis Pharmacy | Department of Veterans Affairs (VA) Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2007-04-20 |
| 1720036171 | Nashville Vamc | Department of Veterans Affairs (VA) Pharmacy | 1310 24th Ave S, Nashville, TN 37212-2637 | 2006-05-05 |
| 1316905904 | Nashville Vamc | Department of Veterans Affairs (VA) Pharmacy | 3400 Lebanon Rd, Murfreesboro, TN 37129-1237 | 2006-05-03 |
| 1386602050 | Memphis Vamc | Department of Veterans Affairs (VA) Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2006-05-03 |
| City | MOUNTAIN CITY |
| Zip Code | 37683 |
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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.