# TRI-MED PHARMACY SERVICES, LLC \#3

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRI-MED PHARMACY SERVICES, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134306012
- **Legal business name:** TRI-MED PHARMACY SERVICES, LLC
- **Authorized official:** MIKE BIRDWELL PHARMD., RPH. (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (423) 664-1217

## Contact information

- **Practice address:** 2195 VARNELL RD SW, CLEVELAND, TN 37311-7347
- **Practice address phone:** (423) 664-1217
- **Mailing address:** 2195 VARNELL RD SW, CLEVELAND, TN 37311-7347
- **Mailing address phone:** (423) 664-1217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 4465 | TN | Yes |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 01/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4465 | BOARD OF PHARMACY | TN |