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FOUNTAIN PLAZA PHARMACY LLC NPI 1821362526


NPI Information

NPI: 1821362526
Provider Name: FOUNTAIN PLAZA PHARMACY LLC

Doing Business As: FOUNTAINRX

Classification: Pharmacy - 3336S0011X
Entity Type: Organization

Specialization: Specialty Pharmacy

Address:
2825 W ANDREW JOHNSON HWY
MORRISTOWN, TN
ZIP 37814
Phone: (423) 307-5757
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FOUNTAIN PLAZA PHARMACY LLC is a specialty pharmacy pharmacy in Morristown, TN. The provider is a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. FOUNTAIN PLAZA PHARMACY LLC NPI is 1821362526. The provider is registered as an organization entity type.
The provider Is Doing Business As Fountainrx.

The provider's business location address is:

2825 W ANDREW JOHNSON HWY
MORRISTOWN, TN
ZIP 37814
Phone: (423) 307-5757
Fax: (423) 307-5241

The provider's authorized official is Joseph Huntsman .
The authorized official title is Partner & Cfo and has the following contact phone number (423) 736-7976.

The enumeration date for this NPI number is 2/28/2012 and was last updated on 10/5/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail Pharmacy2018008256MISSOURINo
23336C0003XPharmacyCommunity/Retail PharmacyOSP.0006973COLORADONo
33336C0003XPharmacyCommunity/Retail Pharmacy054.020619ILLINOISNo
43336C0003XPharmacyCommunity/Retail Pharmacy14556MISSISSIPPINo
53336C0003XPharmacyCommunity/Retail PharmacyTN1923KENTUCKYNo
63336C0003XPharmacyCommunity/Retail PharmacyPHNR001097GEORGIANo
73336C0003XPharmacyCommunity/Retail Pharmacy4998TENNESSEENo
83336C0004XPharmacyCompounding Pharmacy4998TENNESSEENo
93336H0001XPharmacyHome Infusion Therapy PharmacyNo
103336M0002XPharmacyMail Order PharmacyNo
113336S0011XPharmacySpecialty Pharmacy4998TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17Z1164MEDICAIDSOUTH CAROLINA
295213MEDICAIDARIZONA
31821362526MEDICAIDILLINOIS
42134355OTHERPK
54067029MEDICAIDUTAH
6300047862MEDICAIDINDIANA
7431597MEDICAIDOHIO
82018228689MEDICAIDVIRGINIA
9574038MEDICAIDNORTH CAROLINA
107100373620MEDICAIDKENTUCKY
119000202940MEDICAIDCOLORADO
12232282407MEDICAIDARKANSAS
137Z1164MEDICAIDPENNSYLVANIA
14Q035892MEDICAIDTENNESSEE
15103955980001MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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