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Organization

LARCO MEDICAL INC

Active
Other names
Larco Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
RANDY CHAFFIN (PRESIDENT/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
3336L0003X
Long Term Care Pharmacy
Primary
3762
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2160886
PK
Enumeration date
07/13/2016
Last updated
11/02/2016
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