WELLMONT OUTPATIENT PHARMACY
NPI 1275536997
Pharmacy - Community/Retail Pharmacy in Kingsport, TN

Q: What is Medical Mall Pharmacy Inc's NPI number?

The NPI number for Medical Mall Pharmacy Inc is 1275536997. It was assigned to this organization in the NPPES registry on May 27, 2005. The provider is doing business as Wellmont Outpatient Pharmacy.

Q: What is Medical Mall Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since May 27, 2005

130 W RAVINE RD, KINGSPORT, TN 37660(423) 224-6860(423) 224-5654 Get Directions Write a Review

NPPES record last updated: December 3, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Wellmont Outpatient Pharmacy NPPES

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

WELLMONT OUTPATIENT PHARMACY (NPI 1275536997) is a healthcare organization registered as a community/retail pharmacy in Kingsport, Tennessee and active in the NPI registry since May 2005. The organization lists Kristine Hagee, Pharmacy Systems Analyst, as its authorized official.

NPPES Registry Identity

NPI1275536997

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameMEDICAL MALL PHARMACY INC

Location Address130 W RAVINE RDKingsport, TN 37660-3837

Mailing Address130 W Ravine RdKingsport, TN 37660-3837 · (423) 224-6860 · Fax (423) 224-5654

Phone(423) 224-6860

Fax(423) 224-5654

Organization SubpartNo

Authorized OfficialKristine HageePharmacy Systems Analyst · (423) 230-8432

Enumeration DateMay 27, 2005

Last NPPES UpdateDecember 3, 2009

✔ NPI 1275536997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in TN · C3413

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.

Also ListedPharmacyTaxonomy 333600000X

130 W RAVINE RD, Kingsport, TN 37660

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Other Names 1

Doing Business AsWellmont Outpatient Pharmacy

Other Identifiers 3

Other4433378Ncpdp Provider Identification Number

Medicaid8517916VA

Medicaid3130747TN

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.

CLAIRE ELLIOTT PHARMD

Pharmacist

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

WPS PROVIDERS INC

General Practice

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

JAMES ROBERT BECK PHARMACIST

Pharmacist

130 W RAVINE RD, WELLMONT OUTPATIENT PHARMACY
KINGSPORT, TN 37660

Sullivan County (423) 224-6860

MRS. REKHA S GUPTA OTR

Occupational Therapist

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-5535

MRS. STACEY ANN RYDER CRNA

Nurse Anesthetist, Certified Registered

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

DR. HETVI KIRITKUMAR JOSHI M.D.

Hospitalist

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-3628

SHERRY LYNN GOODE NP

Nurse Practitioner (Family)

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-3628

PATRINA NICOLYN CRADIC FNP-C

Nurse Practitioner (Family)

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medical Mall Pharmacy Inc's NPI number?

The NPI number for Medical Mall Pharmacy Inc is 1275536997. It was assigned to this organization in the NPPES registry on May 27, 2005. The provider is doing business as Wellmont Outpatient Pharmacy.

Where is Medical Mall Pharmacy Inc located?

Medical Mall Pharmacy Inc is located at 130 W Ravine Rd, Kingsport, TN 37660. The listed phone number is (423) 224-6860.

What is Medical Mall Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for Medical Mall Pharmacy Inc was last updated on December 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.