Organization
COOKEVILLE DISCOUNT PHARMACY
Active
Other names
COOKEVILLE MED PLUS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CRANFORD (PHARM D)
(931) 528-4634
Entity
Organization
Contact information
Practice address
315 N WASHINGTON AVE, STE 130, COOKEVILLE, TN 38501-2603
(931) 528-4634
(931) 372-1631
Mailing address
315 N WASHINGTON AVE, STE 130, COOKEVILLE, TN 38501-2603
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0000003488
TN
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454201 TN
—
TN
01
—
4433936
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/21/2006
Last updated
02/01/2008
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