Organization
MEDIPHARM DISCOUNT PHARMACY INC.
Active
Other names
MEDIPHARM DISCOUNT PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ROURKE SMITH (PRESIDENT)
(312) 810-2200
Entity
Organization
Contact information
Practice address
1026 N GERMANTOWN PKWY, CORDOVA, TN 38018-5892
(901) 373-9955
(901) 382-9966
Mailing address
1026 N GERMANTOWN PKWY, CORDOVA, TN 38018-5892
(901) 373-9955
(901) 382-9966
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4492
TN
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164121
PK
—
Enumeration date
08/03/2016
Last updated
10/19/2016
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