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General NPI Number Information
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NPI Number | 1417216235
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Entity Type | Organization
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Legal Business Name | LIFE-Q LLC
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 1838 ELM HILL PIKE STE 125
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City | NASHVILLE
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State | TN
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Zip | 37210-3726
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Country | US
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Telephone | 888-948-4633
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Fax | 888-208-1097
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Provider Business Mailing Address
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Address Line | 1 BURTON HILLS BLVD STE 215
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City | NASHVILLE
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State | TN
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Zip | 37215-6293
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Country | US
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Telephone | 888-948-4633
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Fax | 888-208-1097
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | MR. JAMES HAMMETT
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Credential |
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Telephone | 888-948-4633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5008
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License Number State | TN
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