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General NPI Number Information
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NPI Number | 1225603830
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Entity Type | Organization
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Legal Business Name | CAREMAX PHARMACY OF LOUDON, INC
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 601 GRASSMERE PARK STE 19A
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City | NASHVILLE
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State | TN
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Zip | 37211-3681
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Country | US
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Telephone | 629-240-7070
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Fax | 629-895-0115
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Provider Business Mailing Address
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Address Line | 3033 W PRESIDENT GEORGE BUSH HWY # 100
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City | PLANO
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State | TX
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Zip | 75075-5752
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Country | US
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Telephone | 214-542-0550
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Fax |
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | MRS. MARCIA R. LARSEN
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Credential |
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Telephone | 214-542-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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