Community Pharmacy of Smyrna LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5062 Issued in TN

Legal business name

COMMUNITY PHARMACY OF SMYRNA LLC

Practice address

300 Stonecrest Blvd
Ste 130
Smyrna, TN 37167-5688

Phone

(615) 459-5335

Fax

(615) 459-5349

NPI assigned

Jul 31, 2012

Organization subpart

Yes

Parent organization

CUSTOM HEALTHAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jane Garrison

Title

General Manager Custom Health

Phone

(407) 857-2871

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CustomHealth Pharmacy Nashville Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Tax ID family

Community Pharmacy of Smyrna LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Community Pharmacy of Smyrna LLC

  • Long Term Care Pharmacy
  • Smyrna, TN
  • NPI 1164100053
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1144576836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD",
            "address_2": "STE 130",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675688",
            "telephone_number": "615-459-3007",
            "fax_number": "615-459-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD",
            "address_2": "STE 130",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675688",
            "telephone_number": "615-459-5335",
            "fax_number": "615-459-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY OF SMYRNA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CUSTOM HEALTH",
        "enumeration_date": "2012-07-31",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "GENERAL MANAGER CUSTOM HEALTH",
        "authorized_official_telephone_number": "407-857-2871"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "5062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158521",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CustomHealth Pharmacy Nashville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Paige Cohen
• Konstadina Rouvelas Cole, PHARM D
• Ta'Niah Cole
• Michelle Collins
• Community Pharmacy LLC
• Community Pharmacy of Smyrna LLC
• Compassionate Home Care LLC
• Comprehensive Health Services
• Comprehensive Neurolgy Center PLLC
• Heather Marie Compton, OTR/L

• Community/Retail Pharmacy in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.