Middle Tennessee Pharmacy Services LLC

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

0000004147 Issued in TN

Legal business name

MIDDLE TENNESSEE PHARMACY SERVICES LLC

Practice address

336 S Cannon Blvd
Shelbyville, TN 37160-3914

Phone

(931) 684-9987

Fax

(931) 684-9995

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Russ Spivey, D.P.H

Title

Pharmacist in Charge

Phone

(931) 684-9987

Specialties & licenses 5

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1497790786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 S CANNON BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603914",
            "telephone_number": "931-684-9987",
            "fax_number": "931-684-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 S CANNON BLVD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603914",
            "telephone_number": "931-684-9987",
            "fax_number": "931-684-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "SPIVEY",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "931-684-9987",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.P.H"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TN",
            "license": "0000004147",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "TN",
            "license": "0000004147",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "TN",
            "license": "0000004147",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "0000004147",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "TN",
            "license": "0000004147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4438140",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN DME",
            "identifier": "4135181",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN HIT",
            "identifier": "4138194",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE",
            "identifier": "1455133",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amanda Milam, PHARM. D.
• Rachel Lynn Mitchell, MD

• Parenteral & Enteral Nutrition Supplies (DME) in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.