Provider Demographics
NPI:1225049802
Name:GREEN HILLS HEALTH & WELLNESS INC
Entity Type:Organization
Organization Name:GREEN HILLS HEALTH & WELLNESS INC
Other - Org Name:HEALTH AND WELLNESS COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF PHARM
Authorized Official - Phone:615-383-3784
Mailing Address - Street 1:329 21ST AVE N
Mailing Address - Street 2:STE 3
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1839
Mailing Address - Country:US
Mailing Address - Phone:615-383-3784
Mailing Address - Fax:615-292-2762
Practice Address - Street 1:329 21ST AVE N
Practice Address - Street 2:STE 3
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1839
Practice Address - Country:US
Practice Address - Phone:615-383-3784
Practice Address - Fax:615-292-2762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336S0011X
TN000014363336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2089433OtherPK
TN4419518Medicaid