Organization
GOOD SHEPHERD MEDICATION MANAGEMENT
Active
Organization
GOOD SHEPHERD MEDICATION MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL BAKER PHARMD (CEO)
(901) 921-3039
Entity
Organization
Contact information
Practice address
6052 HICKORY RIDGE MALL STE 148, MEMPHIS, TN 38115
(901) 921-3039
Mailing address
2166 CUBA MILLINGTON ROAD, MILLINGTON, TN 38053
(901) 921-3039
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5579
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5579
TENNESSEE BOARD OF PHARMACY
TN
Enumeration date
06/16/2015
Last updated
06/16/2015
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