Loretto Drugs L L C
Organization Active NPI Community/Retail Pharmacy · Loretto, TN
NPI 1043225675 · NPPES record last updated Dec 1, 2016
Key facts
- NPI
- 1043225675
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 3933 (TN)
- Legal business name
- LORETTO DRUGS L L C
- Practice address
- 106 Church St
Loretto, TN 38469-2143 - Phone
- (931) 853-5910
- Fax
- (931) 853-5930
- NPI assigned
- Jul 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Timothy Wayne
- Title
- Pic
- Phone
- (931) 853-5920
Practitioners 2
-
Nicole Tucker McConnell, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200515001288 | TN | Part B Supplier - Pharmacy | 7517398035 | Practice locations: Loretto, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 3933 | TN | Yes |
Addresses
Primary practice location
106 Church St
Loretto, TN 38469-2143
Mailing address
PO Box 278
Loretto, TN 38469-0278
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2093982 | Other | PK |
Other names
- LORETTO DRUGS LLC
Other providers in Loretto, TN
- Inner Roots Behavioral Health PLLC
- Chasy Lynn Jacobs
- John Jacobs II
- Kimberly Lane Johnson
- Loretto Communication Services, Inc.
- Loretto Family Chiropractic
- Matthew E. Schantz, M.D.
- Nicole Tucker McConnell
- Sydney Taylor Phillips
- Red E 2 Ride LLC
All providers in Loretto, TN · Community/Retail Pharmacy in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.