Provider Demographics
NPI:1578637005
Name:FRANKLIN PROFESSIONAL PHARMACY
Entity Type:Organization
Organization Name:FRANKLIN PROFESSIONAL PHARMACY
Other - Org Name:FRANKLIN PROFESSIONAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-790-6369
Mailing Address - Street 1:200 STRAHL ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3556
Mailing Address - Country:US
Mailing Address - Phone:615-790-6369
Mailing Address - Fax:615-791-6943
Practice Address - Street 1:200 STRAHL ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3556
Practice Address - Country:US
Practice Address - Phone:615-790-6369
Practice Address - Fax:615-791-6943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000014653336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3544127Medicaid
4427705OtherNCPDP PROVIDER IDENTIFICATION NUMBER