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NPI Code Detail

MEDICARE: DEBERRY DRUGS INC.

MEDICARE: DEBERRY DRUGS INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy2087TN
23336L0003XLong Term Care Pharmacy
33336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11134117146OTHERTNNPI
24425357OTHERTNNABP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134117146
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEBERRY DRUGS INC.
Provider Business Mailing Address
First Line : 834 MULBERRY AVE
Second Line :
City : SELMER
State : TN
Zip : 38375-2334
Country : US
Telephone Number : 731-645-6100
Fax Number : 731-645-4333
Provider Business Practice Location Address
First Line : 834 MULBERRY AVE
Second Line :
City : SELMER
State : TN
Zip : 38375
Country : US
Telephone Number : 731-645-6100
Fax Number : 731-645-4333
Authorized Official
Title or Position : BOOK KEEPER/CPHT
Name : LAUREN RICKMAN
Credential :
Telephone Number : 731-645-6100
Provider Enumeration Date : 10/12/2005
Last Update Date : 09/25/2024

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Directions to “DEBERRY DRUGS INC. ” Practice Location

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