Organization
CUMBERLAND SPECIAL CARE PHARMACY LLC
Active
Organization
CUMBERLAND SPECIAL CARE PHARMACY LLC
Active
Other names
Cumberland Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON HEADRICK (OWNER/PIC)
(931) 456-0680
Entity
Organization
Contact information
Practice address
3106 MILLER AVE STE 101, CROSSVILLE, TN 38555-6118
(931) 456-0680
(931) 456-4857
Mailing address
PO BOX 2809, CROSSVILLE, TN 38557-2809
(931) 456-0680
(931) 456-4857
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
5708
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157234
PK
—
05
—
Q020116
—
TN
Enumeration date
06/19/2015
Last updated
02/01/2021
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