MEDICARE: SPARTA DRUG CENTER LLC

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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1245872704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARTA DRUG CENTER LLC

Provider Business Mailing Address
First Line	:	425 N SPRING ST
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-1323
Country	:	US
Telephone Number	:	931-837-5000
Fax Number	:	855-644-3200

Provider Business Practice Location Address
First Line	:	425 N SPRING ST
Second Line	:
City	:	SPARTA
State	:	TN
Zip	:	38583-1323
Country	:	US
Telephone Number	:	931-837-5000
Fax Number	:	855-644-3200

Authorized Official
Title or Position	:	LLC MEMBER/PHARMACIST
Name	:	ELIZABETH ANN KIRBY
Credential	:
Telephone Number	:	931-837-5000

Provider Enumeration Date	:	10/16/2019
Last Update Date	:	11/07/2025

Similar Medicare Providers

1023094802 — SABRA C RINIO
Practice Location Address:

425 N SPRING ST
SPARTA, TN
38583-1323

Practice Phone: 931-836-2414
Practice Fax: 931-836-3950

1386999043 — ELIZABETH ANN KIRBY PHARMD
Practice Location Address:

425 N SPRING ST
SPARTA, TN
38583-1323

Practice Phone: 931-837-5000
Practice Fax:

1710824651 — TRUE CARE PERSONAL SUPPORT SERVICES, LLC
Practice Location Address:

114 WINDSOR DR
SPARTA, TN
38583-2300

Practice Phone: 931-644-2214
Practice Fax:

1841942513 — TYLER LIVESAY
Practice Location Address:

550 N SPRING ST
SPARTA, TN
38583-1330

Practice Phone: 931-837-2221
Practice Fax:

1437090529 — COOKEVILLE EYE SPECIALISTS, PLLC
Practice Location Address:

126 E BOCKMAN WAY
SPARTA, TN
38583-2036

Practice Phone: 931-836-2265
Practice Fax: 931-836-3036

1770586679 — STYLIANOS A KAKOULLIS MD
Practice Location Address:

705 HOWELL ST , STE B
SPARTA, TN
38583-1008

Practice Phone: 931-738-4595
Practice Fax: 931-738-4596

Directions to “SPARTA DRUG CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.