Provider Demographics
NPI:1982866240
Name:ORGAIN PHARMACY
Entity Type:Organization
Organization Name:ORGAIN PHARMACY
Other - Org Name:GRAY DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORGAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-943-3266
Mailing Address - Street 1:214 MEADOWLARK CT
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-9050
Mailing Address - Country:US
Mailing Address - Phone:423-943-3266
Mailing Address - Fax:
Practice Address - Street 1:1025 WESTHAVEN BLVD
Practice Address - Street 2:STE 110
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-4894
Practice Address - Country:US
Practice Address - Phone:615-599-8744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4441363OtherNCPDP PROVIDER IDENTIFICATION NUMBER