Provider Demographics
NPI:1033221973
Name:TUNNEL HILL PHARMACY INC
Entity Type:Organization
Organization Name:TUNNEL HILL PHARMACY INC
Other - Org Name:TUNNEL HILL PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWLE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MSE
Authorized Official - Phone:706-673-5211
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:TUNNEL HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30755-0097
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3535 CHATTANOOGA RD
Practice Address - Street 2:
Practice Address - City:TUNNEL HILL
Practice Address - State:GA
Practice Address - Zip Code:30755-9393
Practice Address - Country:US
Practice Address - Phone:706-673-5211
Practice Address - Fax:706-673-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0032543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2012868OtherPK
0763930001Medicare NSC