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General NPI Number Information
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NPI Number | 1821019886
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Entity Type | Organization
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Legal Business Name | NUTRITIONAL SUPPORT SERVICES
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 145 SE PARKWAY STE 170
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City | FRANKLIN
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State | TN
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Zip | 37064-3962
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Country | US
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Telephone | 615-591-1101
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Fax | 615-435-2300
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Provider Business Mailing Address
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Address Line | PO BOX 32249
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City | KNOXVILLE
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State | TN
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Zip | 37930-2249
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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 | EXECUTIVE DIRECTOR
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Name | TERRY LEEMAN
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Credential |
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Telephone | 615-591-1101
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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 | TN1173
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License Number State | KY
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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 | 201425
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 3289
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License Number State | TN
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