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General NPI Number Information
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NPI Number | 1326913872
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Entity Type | Organization
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Legal Business Name | TRICARE PHARMACY LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 710 NASHVILLE PIKE STE 101
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City | GALLATIN
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State | TN
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Zip | 37066-4592
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Country | US
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Telephone | 615-461-7078
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Fax | 615-461-8864
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Provider Business Mailing Address
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Address Line | 710 NASHVILLE PIKE STE 101
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City | GALLATIN
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State | TN
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Zip | 37066-4592
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER & PIC
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Name | JEOBU PETER
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Credential | MPHARM, DPH
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Telephone | 615-461-7078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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