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COLONIAL HEIGHTS PHARMACY
NPI 1619003399
Pharmacy in Kingsport, TN

Active since February 26, 2007CLIA 44D2144718 · Waiver
4221 FT. HENRY DRIVE, KINGSPORT, TN 37663(423) 239-9191(423) 239-0382 Get Directions Write a Review

NPPES record last updated: October 13, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Colonial Heights Pharmacy NPPES

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

COLONIAL HEIGHTS PHARMACY (NPI 1619003399) is a healthcare organization registered as a pharmacy in Kingsport, Tennessee and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through February 21, 2028 and lists Martha M Dunn, Pharmacist / Pic, as its authorized official.

NPPES Registry Identity

NPI1619003399
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameCOLONIAL HEIGHTS PHARMACY, INC.
Location Address4221 FT. HENRY DRIVEKingsport, TN 37663
Mailing Address4221 Ft. Henry DriveKingsport, TN 37663 · (423) 239-9191 · Fax (423) 239-0382
Phone(423) 239-9191
Fax(423) 239-0382
Organization SubpartNo
Authorized OfficialMartha M DunnPharmacist / Pic · (423) 239-9191
Enumeration DateFebruary 26, 2007
Last NPPES UpdateOctober 13, 2016
✔ NPI 1619003399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X · License 500 (TN)
4221 FT. HENRY DRIVE, Kingsport, TN 37663
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Other Names 1

Doing Business AsColonial Heights Pharmacy

Other Identifiers 3

Medicaid1452937TN
Medicare NSC0697160001TN
Medicare ID-Type UnspecifiedC08403557TN

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 44D2144718

Colonial Heights Pharmacy · Kingsport, TN
Active · expires Feb 21, 2028
CLIA Number44D2144718
Laboratory TypePharmacy
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorKimberly V. Odle
Laboratory Phone(423) 239-9191
Laboratory LocationColonial Heights Pharmacy4221 Ft Henry Dr, Kingsport, TN 37663
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Colonial Heights Pharmacy, Inc.'s NPI number?

The NPI number for Colonial Heights Pharmacy, Inc. is 1619003399. It was assigned to this organization in the NPPES registry on February 26, 2007. The provider is doing business as Colonial Heights Pharmacy.

Where is Colonial Heights Pharmacy, Inc. located?

Colonial Heights Pharmacy, Inc. is located at 4221 Ft. Henry Drive, Kingsport, TN 37663. The listed phone number is (423) 239-9191.

What is Colonial Heights Pharmacy, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Colonial Heights Pharmacy, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2144718) is associated with this NPI, valid through February 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Colonial Heights Pharmacy, Inc. was last updated on October 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.