Provider Demographics
NPI:1437132339
Name:METRO MEDICAL SKYLINE PHARMACY LP
Entity Type:Organization
Organization Name:METRO MEDICAL SKYLINE PHARMACY LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. VP METRO MEDICAL PARTNERS INC
Authorized Official - Prefix:MR
Authorized Official - First Name:FLORIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:615-312-9880
Mailing Address - Street 1:200 CUMBERLAND BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1804
Mailing Address - Country:US
Mailing Address - Phone:615-312-9880
Mailing Address - Fax:615-320-5418
Practice Address - Street 1:3443 DICKERSON PIKE STE 110
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2521
Practice Address - Country:US
Practice Address - Phone:615-868-0792
Practice Address - Fax:615-860-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN600332B00000X
TN0000001437333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4428202OtherNCPDP
4428202OtherNCPDP
TN0821130001Medicare ID - Type Unspecified