Organization
MIDDLE TENNESSEE PHARMACY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSS SPIVEY (PHARMACIST IN CHARGE)
(931) 684-9987
Entity
Organization
Contact information
Practice address
336 S CANNON BLVD, SHELBYVILLE, TN 37160-3914
(931) 684-9987
(931) 684-9995
Mailing address
336 S CANNON BLVD, SHELBYVILLE, TN 37160-3914
(931) 684-9987
(931) 684-9995
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0000004147
TN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0000004147
TN
333600000X
Pharmacy
0000004147
TN
3336H0001X
Home Infusion Therapy Pharmacy
Primary
0000004147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4138194
BCBS TN HIT
TN
Enumeration date
04/08/2010
Last updated
04/08/2010
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