Provider Demographics
NPI:1568811099
Name:RMSS LLC
Entity Type:Organization
Organization Name:RMSS LLC
Other - Org Name:FAMILY WELLNESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:CLINT
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-403-2552
Mailing Address - Street 1:330 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2440
Mailing Address - Country:US
Mailing Address - Phone:931-559-6337
Mailing Address - Fax:931-559-1002
Practice Address - Street 1:330 N OAK AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2440
Practice Address - Country:US
Practice Address - Phone:931-559-6337
Practice Address - Fax:931-559-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TN57993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160654OtherPK
TNQ033115Medicaid