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General NPI Number Information
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NPI Number | 1023173036
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Entity Type | Organization
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Legal Business Name | CENTERSTONE PHARMACY
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 620 GALLATIN PIKE S
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City | MADISON
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State | TN
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Zip | 37115-4013
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Country | US
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Telephone | 615-460-4358
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Fax | 615-460-4303
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Provider Business Mailing Address
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Address Line | 620 GALLATIN PIKE S
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City | MADISON
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State | TN
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Zip | 37115-4013
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Country | US
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Telephone | 615-460-4358
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Fax | 615-460-4303
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Authorized Official
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Title or Position | PHARMACY COORDINATOR
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Name | MS. STACY A RICE
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Credential |
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Telephone | 615-460-4358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4061
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License Number State | TN
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Taxonomy #2
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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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