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General NPI Number Information
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NPI Number | 1215176854
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Entity Type | Organization
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Legal Business Name | PRUITTS DISCOUNT PHARMACY
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 811 DICKERSON PIKE STE C
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City | NASHVILLE
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State | TN
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Zip | 37207-5633
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Country | US
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Telephone | 615-562-6337
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Fax | 615-369-8759
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Provider Business Mailing Address
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Address Line | 811 DICKERSON PIKE STE C
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City | NASHVILLE
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State | TN
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Zip | 37207-5633
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Country | US
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Telephone | 615-562-6337
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Fax | 615-369-8759
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. SHAWN PRUITT SR.
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Credential | PHARM.D.
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Telephone | 615-562-6337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 5005
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License Number State | TN
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