Provider Demographics
NPI:1407093230
Name:MONARCH LTC INC.
Entity Type:Organization
Organization Name:MONARCH LTC INC.
Other - Org Name:CORLEY'S PHARMACY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDDINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-630-7030
Mailing Address - Street 1:P.O. BOX 874
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37744
Mailing Address - Country:US
Mailing Address - Phone:423-630-7030
Mailing Address - Fax:423-630-7033
Practice Address - Street 1:1000 MONARCH POINTE
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4656
Practice Address - Country:US
Practice Address - Phone:423-630-7030
Practice Address - Fax:423-630-7033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
TN00000046173336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118579OtherPK