Organization
LAVERGNE FAMILY PHARMACY PC
Active
Other names
Fichtel's Pharmacy, Fichtel Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CALEB GIBBS (VP OF OPERATIONS)
(615) 462-6031
Entity
Organization
Contact information
Practice address
405 OLD NASHVILLE HWY, LA VERGNE, TN 37086-3332
(615) 462-6031
Mailing address
405 OLD NASHVILLE HWY, LA VERGNE, TN 37086-3332
(615) 462-6031
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5467
TN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148227
PK
—
Enumeration date
10/08/2014
Last updated
10/01/2018
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