State of Tennessee
Organization
Active NPI
Clinic Pharmacy · Jackson, TN
NPI 1386863314 · NPPES record last updated Sep 1, 2010
Key facts
- NPI
- 1386863314
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic Pharmacy 3336C0002X
- License
- 443 (TN)
- Legal business name
- STATE OF TENNESSEE
- Practice address
- 295 Summar Dr
Jackson, TN 38301-3905
- Phone
- (731) 421-6732
- Fax
- (731) 935-7093
- NPI assigned
- Apr 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Marilyn Barnes
- Title
- Regional Director
- Phone
- (731) 421-6700
Corporate family (same tax ID) 24
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National Provider Directory
- Tax ID family
- Trousdale County Health (202 organizations share this tax ID)
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Clinic Pharmacy |
3336C0002X |
443 |
TN |
Yes |
Addresses
Primary practice location
295 Summar Dr
Jackson, TN 38301-3905
Mailing address
295 Summar Dr
Jackson, TN 38301-3905
Phone (731) 421-6732
Other names
- West Tennessee Regional Health Pharmacy Other name