Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

TRITENN LLC
NPI 1194812446
Pharmacy - Community/Retail Pharmacy in Johnson City, TN

Active since October 06, 2006CLIA 44D2151971 · Waiver
208 SUNCREST ST UNIT 1, JOHNSON CITY, TN 37615(423) 477-3847(423) 477-4392 Get Directions Write a Review

NPPES record last updated: July 11, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 11, 2026, Apr 30, 2026, Mar 8, 2026 and 2 more (5 updates tracked since 2017).

About Tritenn Llc NPPES

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

TRITENN LLC (NPI 1194812446), doing business as Gray Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Johnson City, Tennessee and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through July 30, 2026 and lists Jordon Thomas Baker, Ceo / Co-owner, as its authorized official.

NPPES Registry Identity

NPI1194812446
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameTRITENN LLC
Location Address208 SUNCREST ST UNIT 1Johnson City, TN 37615-3494
Mailing Address208 Suncrest St Unit 1Johnson City, TN 37615-3494 · (423) 477-3847 · Fax (423) 477-4392
Fax(423) 477-4392
Organization SubpartNo
Authorized OfficialJordon Thomas BakerCeo / Co-owner · (423) 772-3591
Enumeration DateOctober 6, 2006
Last NPPES UpdateJuly 11, 20265 updates tracked since enumeration
NPPES CertifiedJuly 11, 2026
NPI 1194812446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in TN · C001007
Definition

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.

208 SUNCREST ST UNIT 1, Johnson City, TN 37615

Other Names 2

Doing Business AsGray Pharmacy
Doing Business AsTri-cities Pharmacy Of Gray

Other Identifiers 1

Medicaid3539406TN

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2151971

Tritenn LLC Dba Gray Pharmacy · Gray, TN
Active · expires Jul 30, 2026
CLIA Number44D2151971
Laboratory TypePharmacy
Certificate Effective DateJuly 31, 2024
Certificate Expiration DateJuly 30, 2026
Laboratory DirectorClayton F. Kilgore
Laboratory Phone(423) 477-3847
Laboratory LocationTritenn LLC Dba Gray Pharmacy208 Suncrest Drive, Gray, TN 37615
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Pharmacist
208 SUNCREST ST UNIT 1
GRAY, TN 37615
Pharmacist
208 SUNCREST ST UNIT 1
GRAY, TN 37615

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194812446, enumerated as an "organization" on October 06, 2006.

The provider is located at 208 SUNCREST ST UNIT 1 JOHNSON CITY, TN 37615 and the phone number is (423) 477-3847.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.