Pharmblue Tennessee LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0000005865 Issued in TN

Legal business name

PHARMBLUE TENNESSEE LLC

Doing business as

PharmBlue Tennessee LLC

Practice address

1113 Murfreesboro Rd Ste 319-B
Franklin, TN 37064-1306

Phone

(615) 656-5417

Fax

(855) 331-4245

NPI assigned

Jul 7, 2016

Last updated

Mar 31, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Nelson

Title

Owner, Ceo, Ao

Phone

(724) 779-4720

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PharmBlue Tennessee LLC Doing business as

Locations

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1982056529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PENNWOOD PL",
            "address_2": "SUITE 300",
            "city": "WARRENDALE",
            "state": "PA",
            "postal_code": "150866526",
            "telephone_number": "724-779-4720",
            "fax_number": "724-779-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 MURFREESBORO RD STE 319-B",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370641306",
            "telephone_number": "615-656-5417",
            "fax_number": "855-331-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMBLUE TENNESSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-07",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER, CEO, AO",
        "authorized_official_telephone_number": "724-779-4720"
    },
    "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": "0000005865",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162030",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982056529",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharmBlue Tennessee LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jacqueline Nicole Mary Phelps, CGC
• Jessica Diane Phelps, FNP

• Community/Retail Pharmacy in Franklin, TN
• Providers in Franklin, 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 Mar 31, 2017; 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.