Organization
PHIPPS PHARMACY INC
Active
Other names
PHIPPS PHARMACY #3
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ROBERT PHIPPS JR. PHARMD (PRESIDENT & CEO)
(731) 352-0820
Entity
Organization
Contact information
Practice address
10 CHANNING WAY, JACKSON, TN 38305-2010
(731) 512-1002
(731) 512-1009
Mailing address
205B HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-0820
(731) 352-2848
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4440
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518372
—
TN
01
—
4440652
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/28/2007
Last updated
11/17/2015
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