Organization
SOUTHMED LLC
Active
Other names
MEDICAP PHARMACY LTC
Organization subpart
No
Provider details
NPI number
Authorized official
LISA TIMBERLAND PHRM D (OWNER PHARMACIST)
(901) 377-2225
Entity
Organization
Contact information
Practice address
2435 WHITTEN RD, STE 102, MEMPHIS, TN 38133-4715
(901) 377-2225
(901) 377-7992
Mailing address
2435 WHITTEN RD, STE 102, MEMPHIS, TN 38133-4715
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
4367
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4440094
OTHER ID NUMBER
—
Enumeration date
03/01/2007
Last updated
04/22/2008
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