Healthcare Provider Details

I. General information

NPI: 1891753745
Provider Name (Legal Business Name): HOSPITAL DISCOUNT PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 12/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 LEBANON HWY
CARTHAGE TN
37030-2955
US

IV. Provider business mailing address

124 LEBANON HWY
CARTHAGE TN
37030-2955
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-1234
  • Fax: 615-735-1234
Mailing address:
  • Phone: 615-735-1234
  • Fax: 615-735-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1393
License Number StateTN

VIII. Authorized Official

Name: ALAN LONG
Title or Position: OWNER
Credential:
Phone: 615-735-1234