Organization
AMPHARM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN F BRADLEY (AUTHORIZED OFFICIAL)
(615) 595-8383
Entity
Organization
Contact information
Practice address
45 FOREST CV, JACKSON, TN 38301
(731) 847-4013
(731) 847-4016
Mailing address
PO BOX 307, PARSONS, TN 38363-0307
(731) 847-4013
(731) 847-4016
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
0000004982
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4445284
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/10/2012
Last updated
08/29/2018
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