Mountain States Health Alliance
NPI 1548842602ActiveOrganization· Pharmacy· Kingsport, TN
Pharmacy in Kingsport, Tennessee, registered in NPPES in April 2021. The authorized official on file is Mary Lynn Krutak, Evp/Cfo.
Overview
| NPI | 1548842602 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 27, 2021 |
| Last updated in NPPES | Jan 24, 2022 |
| Certified by provider | Jan 24, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Pharmacy, Specialty Pharmacy | 3336S0011X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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