Organization
LARCO MEDICAL INC
Active
Organization
LARCO MEDICAL INC
Active
Other names
LARCO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL CHAFFIN (PRES/CEO)
(931) 528-7573
Entity
Organization
Contact information
Practice address
406 N WHITNEY AVE STE 1, COOKEVILLE, TN 38501-4243
(931) 528-7573
(931) 526-6383
Mailing address
406 N WHITNEY AVE STE 1, COOKEVILLE, TN 38501-4243
(931) 528-7573
(931) 526-6383
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3762
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2093901
PK
—
05
—
3548141
—
TN
Enumeration date
11/15/2012
Last updated
11/02/2016
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