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MOUSE CREEK PHARMACY
NPI 1699271999
Pharmacy - Community/Retail Pharmacy in Cleveland, TN

Active since April 04, 2018CLIA 44D2186201 · Waiver
570 PAUL HUFF PKWY NW, CLEVELAND, TN 37312(423) 790-0443(423) 790-0567 Get Directions Write a Review

NPPES record last updated: April 7, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 7, 2022, Jul 27, 2018 (2 updates tracked since 2018).

About Mouse Creek Pharmacy NPPES

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

MOUSE CREEK PHARMACY (NPI 1699271999) is a healthcare organization registered as a community/retail pharmacy in Cleveland, Tennessee and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through June 14, 2028 and lists Jason Bradley, Owner, as its authorized official.

NPPES Registry Identity

NPI1699271999
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePHARMCO
Location Address570 PAUL HUFF PKWY NWCleveland, TN 37312-2957
Mailing Address570 Paul Huff Pkwy NwCleveland, TN 37312-2957 · (423) 618-6232 · Fax (423) 618-6232
Phone(423) 790-0443
Fax(423) 790-0567
Organization SubpartNo
Authorized OfficialJason BradleyOwner · (423) 790-0443
Enumeration DateApril 4, 2018
Last NPPES UpdateApril 7, 20222 updates tracked since enumeration
NPPES CertifiedApril 7, 2022
✔ NPI 1699271999 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 · 6274
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
570 PAUL HUFF PKWY NW, Cleveland, TN 37312
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Other Names 1

Doing Business AsMouse Creek Pharmacy

Other Identifiers 2

Other2176846Pk
MedicaidQ038185TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mouse Creek Pharmacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateTennesseeEnrollment IDO20211103002751Non-DME Part B · Independent Clinical LaboratoryDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

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 44D2186201

Mouse Creek Pharmacy · Cleveland, TN
Active · expires Jun 14, 2028
CLIA Number44D2186201
Laboratory TypePharmacy
Certificate Effective DateJune 15, 2026
Certificate Expiration DateJune 14, 2028
Laboratory DirectorJason Bradley
Laboratory Phone(423) 790-0443
Laboratory LocationMouse Creek Pharmacy570 Paul Huff Parkway NW, Cleveland, TN 37312
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
45 services43 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
43 services41 patients

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 Pharmco's NPI number?

The NPI number for Pharmco is 1699271999. It was assigned to this organization in the NPPES registry on April 4, 2018. The provider is doing business as Mouse Creek Pharmacy.

Where is Pharmco located?

Pharmco is located at 570 Paul Huff Pkwy NW, Cleveland, TN 37312. The listed phone number is (423) 790-0443.

What is Pharmco's specialty?

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

Is Pharmco enrolled in Medicare?

Yes. Pharmco is registered in the Medicare PECOS enrollment system.

When is Pharmco's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Tennessee, Independent Clinical Laboratory) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Pharmco hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2186201) is associated with this NPI, valid through June 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pharmco accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 47 other insurers list Pharmco as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pharmco was last updated on April 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.