Organization
PROMISECARE PHARMACY LLC
Active
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
Update your record
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