MEDICARE: THE NOWELL CORPORATION

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	332B00000X	Durable Medical Equipment & Medical Supplies	0000000699	TN
2	3336C0004X	Compounding Pharmacy	2306	TN
3	335E00000X	Prosthetic/Orthotic Supplier
4	3336C0003X	Community/Retail Pharmacy	0000002306	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	3913534	OTHER	TN	CIGNA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0570320001	OTHER	TN	BANKERS LIFE &CASUALTY
5	0000002306	OTHER	TN	STATE PHARMACY LICENSE
6	4412677	OTHER	TN	NCPDP
7	5731367	OTHER	TN	AETNA
8	3021490	OTHER	TN	BLUE CROSS BLUE SHIELD
9	591Y1NO	OTHER	TN	BCBS OF MINNESOTA

General Provider Information

NPI Number	:	1467410753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NOWELL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 1036
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-1036
Country	:	US
Telephone Number	:	865-988-0000
Fax Number	:	865-986-1542

Provider Business Practice Location Address
First Line	:	721 HIGHWAY 321 N STE 2
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-5003
Country	:	US
Telephone Number	:	865-988-0000
Fax Number	:	865-986-1542

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH MOSELEY NOWELL JR.
Credential	:	PHARM. D.
Telephone Number	:	865-719-7476

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/07/2023

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Directions to “THE NOWELL CORPORATION ” Practice Location

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