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Organization
UPPER CUMBERLAND RURAL HEALTH LLC
Active
Organization
UPPER CUMBERLAND RURAL HEALTH LLC
Active
Other names
Cookeville Medical Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NAVIN JAIN (CIO)
(931) 854-9113
Entity
Organization
Contact information
Practice address
225 N WILLOW AVE, COOKEVILLE, TN 38501-2335
(931) 284-4084
(931) 854-9100
Mailing address
225 N WILLOW AVE, COOKEVILLE, TN 38501-2335
(931) 284-4084
(931) 854-9100
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5937
TN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167251
PK
—
Enumeration date
01/25/2017
Last updated
11/09/2022
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