Healthcare Provider Details

I. General information

NPI: 1699247783
Provider Name (Legal Business Name): HILLTOP PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2018
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HIGHWAY 149
CLARKSVILLE TN
37040-7237
US

IV. Provider business mailing address

400 HIGHWAY 149
CLARKSVILLE TN
37040-7237
US

V. Phone/Fax

Practice location:
  • Phone: 931-233-0444
  • Fax:
Mailing address:
  • Phone: 931-233-0444
  • Fax: 931-278-6477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRANDON VETTER
Title or Position: SECRETARY
Credential:
Phone: 931-233-0444