Provider Demographics
NPI:1376756676
Name:MCFARLAND PHARMACY INC.
Entity Type:Organization
Organization Name:MCFARLAND PHARMACY INC.
Other - Org Name:MCFARLAND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:B
Authorized Official - Last Name:DEBORD
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT, CPED, COF
Authorized Official - Phone:423-581-1118
Mailing Address - Street 1:167 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4628
Mailing Address - Country:US
Mailing Address - Phone:423-581-1118
Mailing Address - Fax:
Practice Address - Street 1:167 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4628
Practice Address - Country:US
Practice Address - Phone:423-581-1118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN39143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454666Medicaid
4436691OtherOTHER ID NUMBER
TN103G739573OtherTENNESSEE FLU