Provider Demographics
NPI:1568599256
Name:WARREN'S APOTHECARY, INC.
Entity Type:Organization
Organization Name:WARREN'S APOTHECARY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-647-6031
Mailing Address - Street 1:1746 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4561
Mailing Address - Country:US
Mailing Address - Phone:931-647-3031
Mailing Address - Fax:931-572-0899
Practice Address - Street 1:1746 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4561
Practice Address - Country:US
Practice Address - Phone:931-647-3031
Practice Address - Fax:931-572-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3500062Medicaid
TN0277700001Medicare NSC