Organization
ADVANTAGE PHARMACY LLC
Active
Other names
Advantage Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG GILMORE (PRESIDENT)
(800) 662-9220
Entity
Organization
Contact information
Practice address
2175 BUSINESS CENTER DR STE 6, MEMPHIS, TN 38134-5628
(901) 881-9770
(866) 488-7820
Mailing address
2175 BUSINESS CENTER DR, STE. 6, MEMPHIS, TN 38134-5628
(901) 881-9770
(866) 488-7820
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
5094
TN
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4445498
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/27/2012
Last updated
11/27/2012
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