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General NPI Number Information
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NPI Number | 1184360570
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Entity Type | Organization
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Legal Business Name | ASM PHARMACY-TENNESSEE, LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 7665 US HIGHWAY 70 STE 102
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City | BARTLETT
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State | TN
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Zip | 38133-2099
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Country | US
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Telephone | 901-625-3784
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Fax | 901-676-6134
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Provider Business Mailing Address
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Address Line | 224 N PARK AVE
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City | FREMONT
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State | NE
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Zip | 68025-4964
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Country | US
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Telephone | 402-753-2800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WALTER HOFF
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Credential |
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Telephone | 847-680-3515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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