Organization
PHIPPS PHARMACY INC
Active
Other names
PHIPPS PHARMACY #2
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY PHIPPS PHARMD (PRESIDENT CEO)
(731) 352-0820
Entity
Organization
Contact information
Practice address
121 MAPLE ST, BRUCETON, TN 38317-1819
(731) 586-2931
(731) 352-2848
Mailing address
205B HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-0820
(731) 352-2848
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0146
TN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455149
—
TN
01
—
4404644
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/29/2006
Last updated
03/10/2010
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