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General NPI Number Information
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NPI Number | 1730290784
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Entity Type | Organization
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Legal Business Name | PMC HEALTHCARE PHARMACIES LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 1680 CENTURY CENTER PKWY SUITE 15
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City | MEMPHIS
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State | TN
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Zip | 38134-8827
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Country | US
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Telephone | 901-388-4519
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Fax | 901-388-5267
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Provider Business Mailing Address
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Address Line | 3802 CORPOREX PARK DR STE 200
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City | TAMPA
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State | FL
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Zip | 33619-1125
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Country | US
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Telephone | 813-318-6039
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. ALLISON L. BROWN
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Credential |
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Telephone | 502-630-7429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0789
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License Number State | TN
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