Healthcare Provider Details

I. General information

NPI: 1811943848
Provider Name (Legal Business Name): VILLAGE SHOPS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7030 CUMBERLAND GAP PKWY
HARROGATE TN
37752-8232
US

IV. Provider business mailing address

7030 CUMBERLAND GAP PKWY PO BOX 619
HARROGATE TN
37752-8232
US

V. Phone/Fax

Practice location:
  • Phone: 423-869-4707
  • Fax: 423-869-4708
Mailing address:
  • Phone: 423-869-4707
  • Fax: 423-869-4708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0000000413
License Number StateTN

VIII. Authorized Official

Name: MR. JAMES RICHARD NEVILS
Title or Position: OWNER/PHARMACIST
Credential: DPH
Phone: 423-869-4707