Healthcare Provider Details

I. General information

NPI: 1174190649
Provider Name (Legal Business Name): FPBS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 09/13/2023
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 LOBELVILLE HWY
LINDEN TN
37096
US

IV. Provider business mailing address

43 N. BROAD ST
LEXINGTON TN
38351
US

V. Phone/Fax

Practice location:
  • Phone: 931-589-6694
  • Fax: 931-589-6692
Mailing address:
  • Phone: 731-307-5351
  • Fax: 731-249-9972

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. SHERRY MIDDLETON
Title or Position: OWNER
Credential: PHARMD
Phone: 731-602-7752