Organization
PORTLAND PRESCRIPTION SHOP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E STINNETT RPH (CEO)
(270) 392-4248
Entity
Organization
Contact information
Practice address
705 S BROADWAY ST, PORTLAND, TN 37148-1628
(615) 323-5050
(615) 323-5052
Mailing address
705 S BROADWAY ST, P.O. BOX 910, PORTLAND, TN 37148-1628
(615) 323-5050
(615) 323-5052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
3336C0003X
Community/Retail Pharmacy
5451
TN
Other
Enumeration date
09/24/2014
Last updated
08/24/2023
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