Provider Demographics
NPI:1437912680
Name:CUMBERLAND COMPOUNDING PHARMACY, LLC
Entity Type:Organization
Organization Name:CUMBERLAND COMPOUNDING PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BART
Authorized Official - Middle Name:E
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-301-5933
Mailing Address - Street 1:525 METROPLEX DR STE 205
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3140
Mailing Address - Country:US
Mailing Address - Phone:844-201-2640
Mailing Address - Fax:
Practice Address - Street 1:525 METROPLEX DR STE 205
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3140
Practice Address - Country:US
Practice Address - Phone:844-201-2640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy