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Organization

MID-TOWN PHARMACY LLC

Active
Other names
Mid-Town Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
ANN MANLEY RPH (PIC,AO)
(731) 645-7008
Entity
Organization

Contact information

Practice address
270 E COURT AVE STE C, SELMER, TN 38375-2304
(731) 645-7008
(731) 982-7006
Mailing address
270 E COURT AVE, SUITE C, SELMER, TN 38375-2304
(731) 645-7008
(731) 982-7006

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
00004902
TN
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2131475
PK
Enumeration date
07/28/2011
Last updated
09/23/2015
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