Provider Demographics
NPI:1497869408
Name:QUALITY CARE PHARMACY, PLLC
Entity Type:Organization
Organization Name:QUALITY CARE PHARMACY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSYTH
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:731-645-7878
Mailing Address - Street 1:144 HOUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SELMER
Mailing Address - State:TN
Mailing Address - Zip Code:38375-2127
Mailing Address - Country:US
Mailing Address - Phone:731-645-7878
Mailing Address - Fax:
Practice Address - Street 1:144 HOUSTON AVE
Practice Address - Street 2:
Practice Address - City:SELMER
Practice Address - State:TN
Practice Address - Zip Code:38375-2127
Practice Address - Country:US
Practice Address - Phone:731-645-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454669Medicaid
TN1454669Medicaid