NPIMap

Organization Active NPI

Community Pharmacy of Smyrna LLC

Doing business as Customhealth Pharmacy Nashville

  • Long Term Care Pharmacy
  • Smyrna, TN
National Provider Identifier
1164100053
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
COMMUNITY PHARMACY OF SMYRNA LLC
Doing business as
Customhealth Pharmacy Nashville
Practice address
300 Stonecrest Blvd Ste 130
Smyrna, TN 37167-5689
Phone
(615) 459-5335
Fax
(615) 459-5349
NPI assigned
Jul 10, 2023
Organization subpart
Yes
Parent organization
CUSTOM HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Joshua Doty Wilson
Title
Business Development Manager
Phone
(903) 520-1567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

300 Stonecrest Blvd Ste 130
Smyrna, TN 37167-5689

Mailing address

300 Stonecrest Blvd Ste 130
Smyrna, TN 37167-5689
Phone (615) 459-5335

Other names 1

  • CUSTOMHEALTH PHARMACY NASHVILLE Doing business as

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1164100053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 130",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675689",
            "telephone_number": "615-459-5335",
            "fax_number": "615-459-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 130",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675689",
            "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 INC",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "DOTY",
        "authorized_official_title_or_position": "BUSINESS DEVELOPMENT MANAGER",
        "authorized_official_telephone_number": "903-520-1567"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUSTOMHEALTH PHARMACY NASHVILLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.