MEDICARE: PRESCRIPTION SPECIALTIES 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	3336C0004X	Compounding Pharmacy	3594	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4436576	OTHER	TN	NCPDP
2	3594	OTHER	TN	PHARMACY STATE LICENSE #
3	62-1858207	OTHER	TN	FEDERAL TAX ID#

General Provider Information

NPI Number	:	1831357532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESCRIPTION SPECIALTIES LLC.

Provider Business Mailing Address
First Line	:	721 HIGHWAY 321 N
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-5003
Country	:	US
Telephone Number	:	865-986-8633
Fax Number	:	865-988-8387

Provider Business Practice Location Address
First Line	:	721 HIGHWAY 321 N
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-5003
Country	:	US
Telephone Number	:	865-986-8633
Fax Number	:	865-988-8387

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	DR. JOSEPH MOSELEY NOWELL JR.
Credential	:	PHARM. D.
Telephone Number	:	865-986-8633

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	03/07/2023

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Directions to “PRESCRIPTION SPECIALTIES LLC. ” Practice Location

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