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General NPI Number Information
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NPI Number | 1104816354
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Entity Type | Organization
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Legal Business Name | JSM & GHM LLC
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 502 HIGHLAND TERRACE
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City | MURFREESBORO
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State | TN
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Zip | 37130
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Country | US
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Telephone | 615-893-7971
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Fax | 615-893-7972
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Provider Business Mailing Address
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Address Line | 502 HIGHLAND TERRACE
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City | MURFREESBORO
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State | TN
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Zip | 37130
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Country | US
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Telephone | 615-893-7971
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Fax | 615-893-7972
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. JAMES MASON
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Credential | D. PH
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Telephone | 615-893-7971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | C1885
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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