Organization
LIBERTY PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MELVIN MAYS DPH (DPH/OWNER)
(931) 729-3541
Entity
Organization
Contact information
Practice address
1518 HIGHWAY 100 STE 100, CENTERVILLE, TN 37033-1182
(931) 729-3541
(931) 729-4874
Mailing address
PO BOX 258, CENTERVILLE, TN 37033-0258
(931) 729-3541
(931) 729-4874
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
161
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3513015
—
TN
Enumeration date
08/31/2006
Last updated
07/13/2020
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