Provider Demographics
NPI:1790959823
Name:ACME PHARMACY INC
Entity Type:Organization
Organization Name:ACME PHARMACY INC
Other - Org Name:THE MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:B
Authorized Official - Last Name:EPLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-753-2441
Mailing Address - Street 1:1238 EAST JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-1507
Mailing Address - Country:US
Mailing Address - Phone:423-753-2441
Mailing Address - Fax:423-753-0477
Practice Address - Street 1:1238 EAST JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-1507
Practice Address - Country:US
Practice Address - Phone:423-753-2441
Practice Address - Fax:423-753-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TN29523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4441224OtherNCPDP
TNFM0836835OtherDEA
TNFM0836835OtherDEA
TN3910044Medicare PIN