Hartsville Pharmacy LLC.

Organization Active NPI Community/Retail Pharmacy · Hartsville, TN

NPI 1457543084 · NPPES record last updated Nov 24, 2025

Key facts

NPI
1457543084
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
4430 (TN)
Legal business name
HARTSVILLE PHARMACY LLC.
Practice address
207 McMurry Blvd E
Hartsville, TN 37074-1109
Phone
(615) 374-4353
Fax
(615) 374-4355
NPI assigned
Aug 17, 2007
Organization subpart
No

Authorized official

Name
Amy Fowler Broyles, PHARM.D
Title
Owner/Pharmacist
Phone
(615) 374-4353

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930055360 TN DME Supplier - Pharmacy 4688879513 Practice locations: Hartsville, TN
O20130520000476 TN Part B Supplier - Mass Immunization (Roster Biller Only) 4688879513 Practice locations: Hartsville, TN

National Provider Directory

Tax ID family
Hartsville Pharmacy LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 4430 TN Yes

Addresses

Primary practice location

207 McMurry Blvd E
Hartsville, TN 37074-1109

Mailing address

207 McMurry Blvd E
Hartsville, TN 37074-1109
Phone (615) 374-4353

Other providers in Hartsville, TN

All providers in Hartsville, TN · Community/Retail Pharmacy in Tennessee

Sources for this page

Verify at the official NPI Registry.