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NPI Code Detail

MEDICARE: BALLOU PHARMACEUTICAL SERVICES INC

MEDICARE: BALLOU PHARMACEUTICAL SERVICES 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
13336L0003XLong Term Care Pharmacy3660TN
23336C0004XCompounding Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14434988OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1598837395
Entity Type Code : Organization
Provider Name (Legal Business Name) : BALLOU PHARMACEUTICAL SERVICES INC
Provider Business Mailing Address
First Line : 207 HIGHWAY 52 BYP W
Second Line :
City : LAFAYETTE
State : TN
Zip : 37083-1728
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 207 HIGHWAY 52 BYP W
Second Line :
City : LAFAYETTE
State : TN
Zip : 37083-1728
Country : US
Telephone Number : 615-688-6336
Fax Number : 615-688-6338
Authorized Official
Title or Position : PRESIDENT PHARMACIST
Name : ANGELA BALLOU
Credential :
Telephone Number : 615-688-6336
Provider Enumeration Date : 11/15/2006
Last Update Date : 09/11/2025

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Directions to “BALLOU PHARMACEUTICAL SERVICES INC ” Practice Location

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