Provider Demographics
NPI:1497024368
Name:NASHVILLE PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:NASHVILLE PHARMACY SERVICES LLC
Other - Org Name:NPS PHARMACY AT MY HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:615-371-1210
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-0157
Mailing Address - Country:US
Mailing Address - Phone:615-724-0066
Mailing Address - Fax:615-860-4541
Practice Address - Street 1:442 METROPLEX DRIVE SUITE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211
Practice Address - Country:US
Practice Address - Phone:615-724-0066
Practice Address - Fax:615-860-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
TN00000049553336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ035472Medicaid
2133097OtherPK
2133097OtherPK