Organization
PROMISECARE PHARMACY LLC
Active
Other names
PromiseCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BABI TUCKER PHARMD (DIRECTOR OF PHARMACY)
(615) 915-5266
Entity
Organization
Contact information
Practice address
605 BAKERTOWN RD, ANTIOCH, TN 37013-2657
(615) 915-5266
(305) 222-7221
Mailing address
605 BAKERTOWN RD, ANTIOCH, TN 37013-2657
(615) 915-5266
(305) 222-7221
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000004619
TN
3336M0002X
Mail Order Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513392
—
TN
01
—
2118982
PK
—
Enumeration date
02/13/2009
Last updated
08/08/2013
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