SULLIVAN SPECIALTY PHARMACY (NPI# 1821402728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821402728 |
| Entity Type | Organization |
| Organization Name | SULLIVAN SPECIALTY PHARMACY |
| Practice Address |
2204 Pavilion Dr Suite 105 Kingsport TN 37660-4657 |
| Mailing Address |
2204 Pavilion Drive Suite 105 Kingsport TN 37664 |
| Practice Telephone | 4233926109 |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |
| Authorized Official Name | MICHAEL SULLIVAN (DIRECTOR) |
| Authorized Official Telephone | 4233926109 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 5400 | TN | Suppliers |
| Street Address |
2204 PAVILION DR SUITE 105 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245226737 | Rebecca Jane Hamilton | Nurse Practitioner | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2005-09-21 |
| 1720468200 | Mountain States Health Alliance | General Acute Care Hospital | 2204 Pavilion Dr, Suite 115, Kingsport, TN 37660-4657 | 2015-06-01 |
| 1568703437 | Lauren Musick | Pharmacist | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2013-03-02 |
| 1316228075 | Clinchfield Family Medicine, Pllc | Clinic/Center | 2204 Pavilion Dr, Suite 110, Kingsport, TN 37660-4657 | 2011-09-07 |
| 1619265550 | Tennessee Anesthesiology LLC | Nurse Anesthetist, Certified Registered | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2011-07-13 |
| 1396049938 | Blue Ridge Medical Management Corporation | Pediatrics | 2204 Pavilion Dr, Suite 210, Kingsport, TN 37660-4657 | 2010-12-22 |
| 1730401209 | Blue Ridge Medical Management Corporation | Family Medicine | 2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4653 | 2010-02-24 |
| 1518289206 | James Bradley Gaither | Nurse Anesthetist, Certified Registered | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2010-02-22 |
| 1265763668 | Lauren Ambrosia Daley | Nurse Practitioner | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2010-01-25 |
| 1902088644 | James W Denham | Pathology | 2204 Pavilion Dr, Kingsport, TN 37660-4657 | 2007-12-05 |
| Find all providers in the same location | ||||
| 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 Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| 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] |
| 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 | ||||
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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.