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General NPI Number Information
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NPI Number | 1417826728
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Entity Type | Organization
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Legal Business Name | TWELVESTONE MEDICAL, INC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 950 BRECKENRIDGE LN STE 280A
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City | LOUISVILLE
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State | KY
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Zip | 40207-4674
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Country | US
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Telephone | 844-893-0012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12364
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City | MURFREESBORO
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State | TN
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Zip | 37129-0048
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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 | DIRECTOR OF COMPLIANCE
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Name | TARA HARRELSON
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Credential |
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Telephone | 615-278-3278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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