Healthcare Provider Details

I. General information

NPI: 1689187239
Provider Name (Legal Business Name): RMSS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N OAK AVE
COOKEVILLE TN
38501-2440
US

IV. Provider business mailing address

330 N OAK AVE
COOKEVILLE TN
38501-2440
US

V. Phone/Fax

Practice location:
  • Phone: 931-559-6337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5799
License Number StateTN

VIII. Authorized Official

Name: JONATHAN CLINT MELTON
Title or Position: SECRETARY
Credential:
Phone: 931-403-2552