Organization
PHARMACY EXPRESS OF PORTLAND INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BANDY (OWNER)
(615) 325-5600
Entity
Organization
Contact information
Practice address
105 N BROADWAY, PORTLAND, TN 37148-1113
(615) 325-5600
(615) 325-5636
Mailing address
105 N BROADWAY, PORTLAND, TN 37148-1113
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
3896
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4436526
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/30/2006
Last updated
09/11/2025
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