Provider Demographics
NPI:1578676912
Name:FORSHEE/CARDER PHARMACIES, INC.
Entity Type:Organization
Organization Name:FORSHEE/CARDER PHARMACIES, INC.
Other - Org Name:CHEROKEE VITAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:T
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-559-3013
Mailing Address - Street 1:PO BOX 5047
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-5047
Mailing Address - Country:US
Mailing Address - Phone:800-447-4095
Mailing Address - Fax:601-482-7490
Practice Address - Street 1:2850 WESTSIDE DR NW
Practice Address - Street 2:SUITE E
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3503
Practice Address - Country:US
Practice Address - Phone:423-559-3013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2933333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN120329OtherBCBS
TN120329OtherBCBS
0316830001Medicare NSC