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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
About Stedi
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