Provider Demographics
NPI:1609206150
Name:OLDHAM DRUGS, INCORPORATED
Entity Type:Organization
Organization Name:OLDHAM DRUGS, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:615-644-3784
Mailing Address - Street 1:1198 NEW HIGHWAY 52 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTMORELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37186
Mailing Address - Country:US
Mailing Address - Phone:615-644-3784
Mailing Address - Fax:615-644-7455
Practice Address - Street 1:1198 NEW HIGHWAY 52 E
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTMORELAND
Practice Address - State:TN
Practice Address - Zip Code:37186
Practice Address - Country:US
Practice Address - Phone:615-644-3784
Practice Address - Fax:615-644-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7183550001Medicare NSC