Provider Information for 1497790786
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MIDDLE TENNESSEE PHARMACY SERVICES LLC
Organization Subpart: NO
NPI: 1497790786
Last Updated: 2008-06-18
Certification Date:
Certification Date:
Details
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NPI | 1497790786 | ||||||||||||||||||||||||
Enumeration Date | 2006-06-19 | ||||||||||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||||||||||
Status | Active | ||||||||||||||||||||||||
Authorized Official Information | Name: Mr. RUSS SPIVEY D.P.H Title: Pharmacist In Charge Phone: 9316849987 | ||||||||||||||||||||||||
Mailing Address | 336 S CANNON BLVD SHELBYVILLE, TN 37160-3914 United States Phone: 931-684-9987 | Fax:931-684-9995 | ||||||||||||||||||||||||
Primary Practice Address | 336 S CANNON BLVD SHELBYVILLE, TN 37160-3914 United States Phone: 931-684-9987 | Fax:931-684-9995 | ||||||||||||||||||||||||
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