Healthcare Provider Details

I. General information

NPI: 1518305069
Provider Name (Legal Business Name): CAREMAX PHARMACY OF LOUDON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 DENTON RD STE 2
DOTHAN AL
36303-2379
US

IV. Provider business mailing address

3218 MORRIS AVE
KNOXVILLE TN
37909-1527
US

V. Phone/Fax

Practice location:
  • Phone: 334-350-3166
  • Fax: 334-350-3165
Mailing address:
  • Phone: 865-540-1002
  • Fax: 865-540-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateAL

VIII. Authorized Official

Name: MR. RONALD NOLAN SHERRILL
Title or Position: PRESIDENT
Credential: RPH
Phone: 865-540-1002