Provider Demographics
NPI:1497010623
Name:SHELLNUTS ACES INC
Entity Type:Organization
Organization Name:SHELLNUTS ACES INC
Other - Org Name:R & M FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-403-2552
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-0375
Mailing Address - Country:US
Mailing Address - Phone:931-403-2552
Mailing Address - Fax:931-403-2556
Practice Address - Street 1:1970 BRADFORD HICKS DR
Practice Address - Street 2:STE B
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570
Practice Address - Country:US
Practice Address - Phone:931-403-2552
Practice Address - Fax:931-403-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy