Organization
PHARMBLUE TENNESSEE LLC
Active
Organization
PHARMBLUE TENNESSEE LLC
Active
Other names
PharmBlue Tennessee LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL NELSON (OWNER, CEO, AO)
(724) 779-4720
Entity
Organization
Contact information
Practice address
1113 MURFREESBORO RD STE 319-B, FRANKLIN, TN 37064-1306
(615) 656-5417
(855) 331-4245
Mailing address
40 PENNWOOD PL, SUITE 300, WARRENDALE, PA 15086-6526
(724) 779-4720
(724) 779-4721
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000005865
TN
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982056529
—
TN
01
—
2162030
PK
—
Enumeration date
07/07/2016
Last updated
03/31/2017
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