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General NPI Number Information
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NPI Number | 1548453053
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Entity Type | Organization
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Legal Business Name | TRI-MED PHARMACY SERVICES, LLC #2
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 260 W MAIN ST SUITE 217
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3347
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Country | US
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Telephone | 615-826-9393
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Fax | 615-826-0531
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Provider Business Mailing Address
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Address Line | 4005 S MENDENHALL RD SUITE 1
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City | MEMPHIS
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State | TN
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Zip | 38115-5919
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Country | US
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Telephone | 901-366-1988
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Fax | 901-366-1679
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Authorized Official
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Title or Position | CEO
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Name | EDWARD WAYNE SMITH
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Credential | DPH.
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Telephone | 615-826-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0000004372
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License Number State | TN
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