Organization
SOUTHLAND PHARMACY LLC
Active
Organization
SOUTHLAND PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI SCIOSCIA (PHARMACIST IN CHARGE)
(931) 563-0008
Entity
Organization
Contact information
Practice address
482 INTERSTATE DR STE K, MANCHESTER, TN 37355
(615) 788-5998
(931) 954-0524
Mailing address
482 INTERSTATE DR, SUITE K, MANCHESTER, TN 37355-3485
(931) 563-0008
(931) 954-0524
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6298
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177446
PK
—
05
—
Q036024
—
TN
Enumeration date
05/12/2018
Last updated
07/27/2018
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