Provider Demographics
NPI:1376879767
Name:B&B PHARMACY PLLC
Entity Type:Organization
Organization Name:B&B PHARMACY PLLC
Other - Org Name:B&B PHARMACY, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARM.D.
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ADHAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-554-2841
Mailing Address - Street 1:5407 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-4412
Mailing Address - Country:US
Mailing Address - Phone:931-451-7785
Mailing Address - Fax:931-451-7786
Practice Address - Street 1:5407 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-4412
Practice Address - Country:US
Practice Address - Phone:931-451-7785
Practice Address - Fax:931-451-7786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47073336C0003X, 3336C0003X
3336C0004X, 3336M0003X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G738380Medicaid
2122387OtherPK
6842510001Medicare NSC