ETSU CHARITABLE PHARMACY
NPI 1154780716
Pharmacy - Clinic Pharmacy in Johnson City, TN

Q: What is East Tennessee State University's NPI number?

The NPI number for East Tennessee State University is 1154780716. It was assigned to this organization in the NPPES registry on February 11, 2016. The provider is doing business as Etsu Charitable Pharmacy.

Q: What is East Tennessee State University's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Active since February 11, 2016

2151 CENTURY LN, JOHNSON CITY, TN 37604(423) 926-2500(423) 926-5999 Get Directions Write a Review

NPPES record last updated: February 11, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Etsu Charitable Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETSU CHARITABLE PHARMACY (NPI 1154780716) is a healthcare organization registered as a clinic pharmacy in Johnson City, Tennessee and active in the NPI registry since February 2016. The organization lists David D Collins, Cfo, Vp Finance Admin, as its authorized official.

NPPES Registry Identity

NPI1154780716

Entity TypeOrganization

Primary Taxonomy3336C0002X

Legal Business NameEAST TENNESSEE STATE UNIVERSITY

Location Address2151 CENTURY LNJohnson City, TN 37604-4469

Mailing AddressPo Box 70403Johnson City, TN 37614-1703 · (423) 439-4071 · Fax (423) 439-4060

Phone(423) 926-2500

Fax(423) 926-5999

Organization SubpartNo

Authorized OfficialDavid D CollinsCfo, Vp Finance Admin · (423) 439-5884

Enumeration DateFebruary 11, 2016

✔ NPI 1154780716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers

Taxonomy Code3336C0002X

License✔ Licensed in TN · 5399

Definition

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

2151 CENTURY LN, Johnson City, TN 37604

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Other Names 1

Doing Business AsEtsu Charitable Pharmacy

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. REBECCA ELLEN FLORA-WATERMAN APRN, FNP

Nurse Practitioner (Primary Care)