OrganizationActiveAccepts Medicare
Maynardville Drug LLC
NPI 1053963975 · Community/Retail Pharmacy · Maynardville, TN
Enrolled with Medicare as Part B Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1053963975
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michelle Halford, Owner/Pic(865) 278-7895
Specialties & taxonomies
Suppliers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2975 Maynardville Hwy
Maynardville, TN 37807
Phone: (865) 658-5353
Fax: (865) 658-5354
Street-level locationGet directions
Mailing address
Po Box 990
New Tazewell, TN 37824-0990
Registry dates
- Enumerated
- 2019-07-11
- Last updated
- 2021-01-06
- Certified
- 2021-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.