Organization
CARTERS COMPOUNDING PHARMACY
Active
Other names
CARTERS COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY DAMRON RPH (OWNER AND PHARM)
(931) 433-1511
Entity
Organization
Contact information
Practice address
106 ELK AVE S, STE B, FAYETTEVILLE, TN 37334-3050
(931) 433-1511
(931) 433-6854
Mailing address
106 ELK AVE S, STE B, FAYETTEVILLE, TN 37334-3050
(931) 433-1511
(931) 433-6854
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
0000003710
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4435853
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/08/2006
Last updated
09/27/2010
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