MEDICAL MALL PHARMACY INC (NPI# 1598768699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598768699 |
Entity Type | Organization |
Organization Name | MEDICAL MALL PHARMACY INC |
Other Organization Name | MEDICAL MALL PHARMACY |
Practice Address |
1 Medical Park Blvd Suite 106-e Bristol TN 37620-7430 |
Mailing Address |
1 Medical Park Blvd Ste 106 Bristol TN 37620-7430 |
Practice Telephone | 4238442888 |
Practice Fax Number | 4238442891 |
Enumeration Date | 2005-05-23 |
Last Update Date | 2009-04-30 |
Authorized Official Name | KRISTINE HAGEE (PHARMACY SYSTEMS ANALYST) |
Authorized Official Telephone | 4232308432 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2964 | TN | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 4428719 | 01 | |
TN | 008503257 | 05 |
Other Name | Type Code |
---|---|
MEDICAL MALL PHARMACY | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275536997 | Medical Mall Pharmacy Inc | Pharmacy | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2005-05-27 |
1316191349 | Medical Mall Pharmacy Inc | Pharmacy | 105 W Stone Dr, Suite 1-b, Kingsport, TN 37660-3256 | 2008-11-04 |
Street Address |
1 MEDICAL PARK BLVD SUITE 106-E |
City | BRISTOL |
State | TN |
Zip Code | 37620-7430 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225640980 | Amanda Marshall | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7453 | 2020-08-23 |
1336764406 | Maggie Mullins | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-06-14 |
1578188249 | Angela Dawn Owens | Pharmacist | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-06-09 |
1528683133 | Jessica Dawn Anderson | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-06-09 |
1659904837 | Sarah Elizabeth Smith | Nurse Anesthetist, Certified Registered | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-02-17 |
1063055762 | Chelsea Newsome | Nurse Practitioner | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2019-10-25 |
1750943718 | Sara Anne Mcglothlin | Occupational Therapy Assistant | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2019-06-30 |
1801355359 | Aaron Allen Kelley | Respiratory Therapist, Registered | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2019-03-14 |
1164922076 | Neha D Naik | Pharmacist | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2018-02-16 |
1386157378 | Matthew S Lowe | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2017-11-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
Find all providers in zip 37620 |
Taxonomy Code | 3336C0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Community/Retail Pharmacy |
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
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 |
---|---|---|---|---|
1881150811 | Wilson Pharmacy, Inc. | Pharmacy | 350 Blountville Hwy Ste 102, Bristol, TN 37620-1676 | 2019-02-14 |
1609346543 | Bristol Discount Pharmacy Inc | Pharmacy | 247 Mill St, Bristol, PA 19007-4803 | 2018-12-04 |
1407950207 | Rhode Island Cvs Pharmacy, L.L.C. | Pharmacy | 400 Metacom Ave, Bristol, RI 02809-5188 | 2006-09-12 |
1083717722 | Virginia Cvs Pharmacy L L C | Pharmacy | 31 E Valley Dr, Bristol, VA 24201-2822 | 2006-09-07 |
1205939907 | Tennessee Cvs Pharmacy LLC | Pharmacy | 3030 W State St, Bristol, TN 37620-1719 | 2006-09-07 |
1548363237 | Tennessee Cvs Pharmacy, L.L.C. | Pharmacy | 1379 Volunteer Pkwy, Bristol, TN 37620-5709 | 2006-09-07 |
1568477529 | Walgreen Co | Pharmacy | 1460 Lee Hwy, Bristol, VA 24201-2865 | 2006-07-29 |
1700805934 | Professional Pharmaceutical Services, Inc. | Pharmacy | 1883 Euclid Ave, Bristol, VA 24201-3605 | 2006-07-19 |
1043243439 | Pharmacy Investment Coordinators Inc | Pharmacy | 11049 Nw State Road 20, Bristol, FL 32321-6406 | 2006-07-08 |
1275133969 | Bristol Health Pharmacy, LLC | Pharmacy | 41 Brewster Rd, Bristol, CT 06010-5161 | 2020-10-30 |
Find all providers in BRISTOL |
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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.