Organization
SHELLNUTS ACES INC
Active
Organization
SHELLNUTS ACES INC
Active
Other names
R & M Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MELTON (PHARMACIST)
(931) 261-6332
Entity
Organization
Contact information
Practice address
1970 BRADFORD HICKS DR STE B, LIVINGSTON, TN 38570-2247
(931) 403-2552
(931) 403-2556
Mailing address
PO BOX 375, LIVINGSTON, TN 38570-0375
(931) 403-2552
(931) 403-2556
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4949
TN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530527
—
TN
01
—
2132695
PK
—
Enumeration date
11/29/2011
Last updated
06/25/2015
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