Provider Demographics
NPI:1174506059
Name:METRO MEDICAL PHARMACY INC.
Entity Type:Organization
Organization Name:METRO MEDICAL PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FLORIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:615-312-9880
Mailing Address - Street 1:200 CUMBERLAND BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1804
Mailing Address - Country:US
Mailing Address - Phone:615-312-9880
Mailing Address - Fax:615-320-5418
Practice Address - Street 1:1911 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2203
Practice Address - Country:US
Practice Address - Phone:615-329-3150
Practice Address - Fax:615-329-1461
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO MEDICAL SUPPLY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-23
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN412332B00000X
TN0000000983333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4422452OtherNCPDP
TN1452515Medicaid
TN1452515Medicaid