Healthcare Provider Details

I. General information

NPI: 1598837395
Provider Name (Legal Business Name): BALLOU PHARMACEUTICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 HIGHWAY 52 BYP W
LAFAYETTE TN
37083-1728
US

IV. Provider business mailing address

207 HIGHWAY 52 BYP W
LAFAYETTE TN
37083-1728
US

V. Phone/Fax

Practice location:
  • Phone: 615-688-6336
  • Fax: 615-688-6338
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number3660
License Number StateTN

VIII. Authorized Official

Name: ANGELA BALLOU
Title or Position: PRESIDENT PHARMACIST
Credential:
Phone: 615-688-6336