Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Peytliv Inc

Organization Durable Medical Equipment & Medical Supplies · NPI 1184114613

Peytliv Inc is a Durable Medical Equipment & Medical Supplies in New Tazewell, Tennessee. Works from 2 locations. Licensed in Kentucky.

Licensed in
KY
In the registry since
2018
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

915 N Broad St
New Tazewell, TN 37825-6633
Phone: (423) 626-5511
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1841 N 25th St, Middlesboro, KY 40965-1853 — (606) 248-9330

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence PO7862 (KY)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1184114613
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Detra Robertson — Pharmacist/Owner · (606) 248-9330
Other names Crater City Pharmacy
NPI enumeratedMay 10, 2018
Last updated in NPPESSeptember 19, 2025
Certification dateOctober 16, 2023
Mailing address1841 N 25th St, Middlesboro, KY 40965-1853

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