Provider Demographics
NPI:1255685384
Name:SCOTTS HILL DISCOUNT DRUGS,LLC
Entity Type:Organization
Organization Name:SCOTTS HILL DISCOUNT DRUGS,LLC
Other - Org Name:SCOTTS HILL DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:731-614-4259
Mailing Address - Street 1:148 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351
Mailing Address - Country:US
Mailing Address - Phone:731-968-4201
Mailing Address - Fax:731-967-5222
Practice Address - Street 1:640 HIGHWAY 114 SOUTH
Practice Address - Street 2:
Practice Address - City:SCOTTS HILL
Practice Address - State:TN
Practice Address - Zip Code:38374-5023
Practice Address - Country:US
Practice Address - Phone:731-549-3927
Practice Address - Fax:731-549-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4445501OtherNCPDP
TN3538371Medicare PIN