Organization
PHARMCO
Active
Organization
PHARMCO
Active
Other names
Mouse Creek Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BRADLEY (OWNER)
(423) 790-0443
Entity
Organization
Contact information
Practice address
570 PAUL HUFF PKWY NW, CLEVELAND, TN 37312-2957
(423) 790-0443
(423) 790-0567
Mailing address
570 PAUL HUFF PKWY NW, CLEVELAND, TN 37312-2957
(423) 618-6232
(423) 618-6232
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6274
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176846
PK
—
05
—
Q038185
—
TN
Enumeration date
04/04/2018
Last updated
04/07/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up