Organization
LA VERGNE DRUG INC
Active
Other names
La Vergne Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ELEDGE DPH (PRESIDENT)
(615) 213-1203
Entity
Organization
Contact information
Practice address
5148B MURFREESBORO RD, LA VERGNE, TN 37086-2712
(615) 213-1203
(615) 213-1530
Mailing address
PO BOX 1358, LA VERGNE, TN 37086-1358
(615) 213-1203
(615) 213-1530
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TN
333600000X
Pharmacy
Primary
3988
TN
Other
Enumeration date
02/08/2007
Last updated
11/29/2011
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