Organization
MAIN STREET PHARMACY OF BROWNSVILLE LLC
Active
Other names
Main Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN PRIMROSE RPH (OWNER/PHARMASICT IN CHARGE)
(731) 772-6246
Entity
Organization
Contact information
Practice address
200 E MAIN ST, BROWNSVILLE, TN 38012-2147
(731) 585-0500
(731) 585-0506
Mailing address
200 E MAIN ST, BROWNSVILLE, TN 38012-2147
(731) 585-0500
(731) 585-0506
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5116
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137828
PK
—
Enumeration date
11/15/2012
Last updated
02/20/2017
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