Provider Demographics
NPI:1326767286
Name:PRUITT'S PHARMACY IN MURFREESBORO
Entity Type:Organization
Organization Name:PRUITT'S PHARMACY IN MURFREESBORO
Other - Org Name:PRUITT'S PHARMACY IN MURFREESBORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRUITT
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:615-415-7247
Mailing Address - Street 1:1107 BRADYVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-5634
Mailing Address - Country:US
Mailing Address - Phone:615-415-7247
Mailing Address - Fax:
Practice Address - Street 1:1107 BRADYVILLE PIKE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5634
Practice Address - Country:US
Practice Address - Phone:615-415-7247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy