Provider Demographics
NPI:1629244900
Name:COMMUNITY DRUG CORPORATION
Entity Type:Organization
Organization Name:COMMUNITY DRUG CORPORATION
Other - Org Name:COMMUNITY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:D PH
Authorized Official - Phone:615-847-5527
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37070-1267
Mailing Address - Country:US
Mailing Address - Phone:615-847-5527
Mailing Address - Fax:615-847-2858
Practice Address - Street 1:862 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-3331
Practice Address - Country:US
Practice Address - Phone:615-847-5527
Practice Address - Fax:615-847-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TN45073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4441250OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6258760001Medicare NSC