Provider Demographics
NPI:1417216235
Name:LIFE-Q LLC
Entity Type:Organization
Organization Name:LIFE-Q LLC
Other - Org Name:LIFE-Q PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-948-4633
Mailing Address - Street 1:1 BURTON HILLS BLVD
Mailing Address - Street 2:STE 215
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6293
Mailing Address - Country:US
Mailing Address - Phone:888-948-4633
Mailing Address - Fax:888-208-1097
Practice Address - Street 1:1838 ELM HILL PIKE
Practice Address - Street 2:STE 125
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-3726
Practice Address - Country:US
Practice Address - Phone:888-948-4633
Practice Address - Fax:888-208-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy