Healthcare Provider Details

I. General information

NPI: 1174506059
Provider Name (Legal Business Name): METRO MEDICAL PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 CHURCH ST
NASHVILLE TN
37203-2203
US

IV. Provider business mailing address

200 CUMBERLAND BND
NASHVILLE TN
37228-1804
US

V. Phone/Fax

Practice location:
  • Phone: 615-329-3150
  • Fax: 615-329-1461
Mailing address:
  • Phone: 615-312-9880
  • Fax: 615-320-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0000000983
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number412
License Number StateTN

VIII. Authorized Official

Name: MR. FLORIS H TOMPKINS III
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 615-312-9880