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Organization

WEST TN PHARMACEUTICAL CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA SHOFE RPH (MEMBER, MANAGER)
(731) 554-9872
Entity
Organization

Contact information

Practice address
24 NOLAN CV, JACKSON, TN 38305
(731) 554-9872
(731) 554-9874
Mailing address
24 NOLAN COVE, JACKSON, TN 38305
(731) 554-9872
(731) 554-9874

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
4669
TN
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1517572
TN
Enumeration date
07/07/2009
Last updated
01/04/2019
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