Organization
FIRST PHARMACY SERVICES OF PARK AVE INC
Active
Other names
First Pharmacy Services of Park Ave
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE PRATT (PHARMACIST)
(901) 821-8330
Entity
Organization
Contact information
Practice address
6005 PARK AVE STE 630B, MEMPHIS, TN 38119-5226
(901) 821-8330
(901) 821-8350
Mailing address
PO BOX 47, POPE, MS 38658
(901) 946-1375
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4571
TN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117378
PK
—
Enumeration date
10/10/2008
Last updated
07/19/2018
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