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Organization

SPARTA APOTHECARY INC

Active
Other names
PAYLESS FAMILY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER TATUM-CRANFORD PHARM D (PRESIDENT)
(931) 836-3187
Entity
Organization

Contact information

Practice address
285 W TURN TABLE RD, SPARTA, TN 38583-1366
(931) 836-3187
(931) 837-9339
Mailing address
285 W TURN TABLE RD, SPARTA, TN 38583-1366
(931) 836-3187
(931) 836-3398

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
0000002929
TN
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2091619
PK
05
9449894
TN
Enumeration date
09/12/2006
Last updated
05/14/2019
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