CRATER CITY PHARMACY
NPI 1184114613
Pharmacy - Community/Retail Pharmacy in New Tazewell, TN
NPI Status: Active since May 10, 2018
Contact Information
915 N BROAD ST
NEW TAZEWELL, TN
ZIP 37825
Phone: (423) 626-5511
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Accepts Insurance
About CRATER CITY PHARMACY
This page provides the complete NPI Profile along with additional information for Crater City Pharmacy, a provider established in New Tazewell, Tennessee operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1184114613 assigned on May 2018. The practitioner's primary taxonomy code is 3336C0003X with license number PO7862 (KY). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Crater City Pharmacy. The authorized official of this NPI record is Detra Robertson (Pharmacist/owner)
- NPI
- 1184114613
- Provider Legal Name
- PEYTLIV INC
- Other Organization Name
- CRATER CITY PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 915 N BROAD ST NEW TAZEWELL, TN 37825
- Location Phone
- (423) 626-5511
- Mailing Address
- 1841 N 25TH ST MIDDLESBORO, KY 40965
- Mailing Phone
- (606) 248-9330
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-10-2018
- Last Update Date
- 10-15-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- PO7862
- License State
- KY
- Taxonomy Description
- A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 2025 HMO 1500 Elite Gold - HMO
- 2025 HMO 5000 Elite Silver - HMO
- 2025 HMO 9200 Elite Catastrophic - HMO
- 2025 POS 1000 Elite Gold - POS
- 2025 POS 1500 Elite Gold - POS
- 2025 POS 2500 Elite Gold - POS
- 2025 POS 4200 Elite Silver - POS
- 2025 POS 5000 Elite Silver - POS
- 2025 POS 6500 Elite Bronze - POS
- 2025 POS 7250 Elite Silver - POS
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze $0 Copay PCP Visits - PPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Bronze Premier - PPO
- Balance by Medica Catastrophic - EPO
- Balance by Medica Catastrophic - PPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Expanded Bronze Standard - PPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold $0 Copay PCP Visits - PPO
- Moda Health Affinity Bronze 7750 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Essential Bronze 6500 - POS
- Essential Gold 1500 - POS
- Freedom Silver 4000 - POS
- Savings Bronze 7700 - POS
- Standard Bronze 7500 - POS
- Standard Gold 1500 - POS
- Standard Silver 5000 - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2177440 | OTHER (01) | PK |
Reviews for CRATER CITY PHARMACY
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 8 | 4 | 1 | 1 | 4 | 6 | 1 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 16 | 4 | 2 | 1 | 8 | 6 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 6 + 4 + 2 + 1 + 8 + 6 + 2 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1184114613 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1679853303 | DR. LLOYD BENTON HARRIS III PHARM D Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1003193624 | ANDREA BROOKE MIRACLE PHARM. D Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1669084711 | DR. DUSTIN SCOTT TAYLOR PHARMD Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1164029435 | AMBER BLEVINS Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1083494058 | BRITNEY MONIQUE GOINS PHARMD Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1194996942 | WALGREEN CO. Organization | Pharmacy | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1558490482 | DR. DETRA LYNN ROBERTSON PHARM.D. Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1801627914 | ALEXA JADE BAYLESS PHARMD Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (423) 626-5511 |
| 1982406005 | ASHLYN JONES Individual | Pharmacist | 915 N BROAD ST NEW TAZEWELL, TN 37825 (606) 499-6960 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184114613, enumerated in the NPI registry as an "organization" on May 10, 2018
The provider is located at 915 N Broad St New Tazewell, Tn 37825 and the phone number is (423) 626-5511
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Health Alliance, Medica, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on May 10, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.