Provider Demographics
NPI: | 1245388768 |
---|---|
Name: | PHARMSCRIPT OF TN LLC |
Entity Type: | Organization |
Organization Name: | PHARMSCRIPT OF TN LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CONTROLLER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHANA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HOFF |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 908-389-1818 |
Mailing Address - Street 1: | P.O. BOX 5831 |
Mailing Address - Street 2: | |
Mailing Address - City: | SOMERSET |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08875 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 908-389-1818 |
Mailing Address - Fax: | 732-868-9014 |
Practice Address - Street 1: | 709 CASTLE HT COURT |
Practice Address - Street 2: | |
Practice Address - City: | LEBANON |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37087 |
Practice Address - Country: | US |
Practice Address - Phone: | 908-389-1818 |
Practice Address - Fax: | 732-868-9014 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-08 |
Last Update Date: | 2019-07-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 3336L0003X | Suppliers | Pharmacy | Long Term Care Pharmacy | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
3914331 | Medicare ID - Type Unspecified |