Healthcare Provider Details

I. General information

NPI: 1437132339
Provider Name (Legal Business Name): METRO MEDICAL SKYLINE PHARMACY LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 DICKERSON PIKE STE 110
NASHVILLE TN
37207-2521
US

IV. Provider business mailing address

200 CUMBERLAND BND
NASHVILLE TN
37228-1804
US

V. Phone/Fax

Practice location:
  • Phone: 615-868-0792
  • Fax: 615-860-4541
Mailing address:
  • Phone: 615-312-9880
  • Fax: 615-320-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number600
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0000001437
License Number StateTN

VIII. Authorized Official

Name: MR. FLORIS H TOMPKINS III
Title or Position: EXEC. VP METRO MEDICAL PARTNERS INC
Credential:
Phone: 615-312-9880