Provider Demographics
NPI:1730297490
Name:APPLE RX, LLC
Entity Type:Organization
Organization Name:APPLE RX, LLC
Other - Org Name:APPLE DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BULLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:865-457-0300
Mailing Address - Street 1:520 CLINCH AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-4206
Mailing Address - Country:US
Mailing Address - Phone:865-457-0300
Mailing Address - Fax:865-457-1383
Practice Address - Street 1:520 CLINCH AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-4206
Practice Address - Country:US
Practice Address - Phone:865-457-0300
Practice Address - Fax:865-457-1383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001743183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3552276Medicaid
TN3552276Medicaid
TN0720800001Medicare NSC