Organization
PHARMACEUTICAL SERVICE INC
Active
Other names
VANS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY TEAL DPH, BS PHARMCY (PIC / VP OPS / OWNER)
(731) 587-9509
Entity
Organization
Contact information
Practice address
116 COMMONS DR, MARTIN, TN 38237-3879
(731) 587-9509
(731) 587-6528
Mailing address
116 COMMONS DR, MARTIN, TN 38237-3879
(731) 587-9509
(731) 587-6528
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0000000661
TN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095781
PK
—
05
—
3557923
—
TN
Enumeration date
07/22/2006
Last updated
04/20/2015
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