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General NPI Number Information
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NPI Number | 1134117146
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Entity Type | Organization
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Legal Business Name | DEBERRY DRUGS INC.
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 834 MULBERRY AVE
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City | SELMER
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State | TN
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Zip | 38375
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Country | US
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Telephone | 731-645-6100
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Fax | 731-645-4333
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Provider Business Mailing Address
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Address Line | 834 MULBERRY AVE
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City | SELMER
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State | TN
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Zip | 38375-2334
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Country | US
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Telephone | 731-645-6100
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Fax | 731-645-4333
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Authorized Official
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Title or Position | BOOK KEEPER/CPHT
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Name | LAUREN RICKMAN
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Credential |
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Telephone | 731-645-6100
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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 | 2087
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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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Taxonomy #3
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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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