Provider Demographics
NPI:1184629362
Name:BUCHHEIT DRUG CORPORATION
Entity Type:Organization
Organization Name:BUCHHEIT DRUG CORPORATION
Other - Org Name:MEDI-THRIFT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER - PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAYELLA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:931-879-8133
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-0610
Mailing Address - Country:US
Mailing Address - Phone:931-879-8133
Mailing Address - Fax:931-879-9365
Practice Address - Street 1:346 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3407
Practice Address - Country:US
Practice Address - Phone:931-879-8133
Practice Address - Fax:931-879-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183500000X, 261Q00000X
TN0000001962333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3559215Medicaid
TN0479530001Medicare NSC