MEDICARE: ABOVE & BEYOND MEDICAL CORPORATION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy	0000005466	TN
2	3336L0003X	Long Term Care Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2159819	OTHER		PK

General Provider Information

NPI Number	:	1033512884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE & BEYOND MEDICAL CORPORATION, LLC

Provider Business Mailing Address
First Line	:	418 S GAY ST
Second Line	:	STE 104
City	:	KNOXVILLE
State	:	TN
Zip	:	37902-1134
Country	:	US
Telephone Number	:	865-692-1603
Fax Number	:	865-692-1604

Provider Business Practice Location Address
First Line	:	418 S GAY ST
Second Line	:	STE 104
City	:	KNOXVILLE
State	:	TN
Zip	:	37902-1134
Country	:	US
Telephone Number	:	865-692-1605
Fax Number	:	865-692-1604

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	RONALD NOLAN SHERRILL
Credential	:
Telephone Number	:	865-692-1603

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	05/23/2025

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Directions to “ABOVE & BEYOND MEDICAL CORPORATION, LLC ” Practice Location

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