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General NPI Number Information
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NPI Number | 1821362526
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Entity Type | Organization
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Legal Business Name | FOUNTAIN PLAZA PHARMACY, LLC
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 2825 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814
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Country | US
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Telephone | 423-307-5757
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Fax | 423-307-5241
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Provider Business Mailing Address
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Address Line | 2825 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-3216
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Country | US
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Telephone | 423-307-5757
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Fax | 423-307-5241
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Authorized Official
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Title or Position | PARTNER & CFO
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Name | JOSEPH HUNTSMAN
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Credential | MBA MA
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Telephone | 423-736-7976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2018008256
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | OSP.0006973
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054.020619
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 14556
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | TN1923
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHNR001097
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 4998
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 4998
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License Number State | TN
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Taxonomy #9
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 4998
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License Number State | TN
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