OrganizationActive
Peytliv Inc
NPI 1184114613 · Community/Retail Pharmacy · New Tazewell, TN
Peytliv Inc is a Community/Retail Pharmacy organization in New Tazewell, TN (NPI 1184114613).
Provider details
- NPI number
- 1184114613
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Detra Robertson, Pharmacist/Owner(606) 248-9330
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
915 N Broad St
New Tazewell, TN 37825-6633
Phone: (423) 626-5511
Street-level locationGet directions
Mailing address
1841 N 25th St
Middlesboro, KY 40965-1853
Other names (DBA / former)
- Doing business as
- Crater City Pharmacy
Additional practice locations (1)
- 1841 N 25th StMiddlesboro, KY 40965-1853Phone: (606) 248-9330Fax: (606) 248-9337
Registry dates
- Enumerated
- 2018-05-10
- Last updated
- 2025-09-19
- Certified
- 2023-10-16
Frequently asked questions
- What is Peytliv Inc's NPI number?
- Peytliv Inc's National Provider Identifier (NPI) is 1184114613, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Peytliv Inc?
- Peytliv Inc is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Peytliv Inc located?
- Peytliv Inc's practice location on file with NPPES is 915 N Broad St, New Tazewell, TN 37825-6633.
- What is Peytliv Inc's phone number?
- The practice phone number listed in the NPPES registry for Peytliv Inc is (423) 626-5511.
- Who is the authorized official for Peytliv Inc?
- The authorized official listed on Peytliv Inc's NPPES record is Detra Robertson, Pharmacist/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Peytliv Inc's NPI active?
- Yes — Peytliv Inc's NPI (1184114613) is active in the NPPES registry as of the last update on 2025-09-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.