Provider Demographics
NPI:1750329272
Name:GEAN GROUP HENDERSON
Entity Type:Organization
Organization Name:GEAN GROUP HENDERSON
Other - Org Name:DEE'S DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:GEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:931-676-3318
Mailing Address - Street 1:689 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340
Mailing Address - Country:US
Mailing Address - Phone:731-989-7180
Mailing Address - Fax:731-989-9109
Practice Address - Street 1:689 KIMBERLY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340
Practice Address - Country:US
Practice Address - Phone:731-989-7180
Practice Address - Fax:731-989-9109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7703183500000X
332B00000X
TN34183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1452448Medicaid