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General NPI Number Information
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NPI Number | 1003381039
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Entity Type | Organization
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Legal Business Name | COOKEVILLE PHARMACY LLC
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 305 W SPRING ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-3125
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Country | US
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Telephone | 931-372-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 GLEN EDEN DR
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City | NASHVILLE
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State | TN
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Zip | 37205-3433
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Country | US
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Telephone | 615-330-8485
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANDREW HIRT
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Credential |
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Telephone | 615-330-8485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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