Provider Demographics
NPI:1821019886
Name:NUTRITIONAL SUPPORT SERVICES
Entity Type:Organization
Organization Name:NUTRITIONAL SUPPORT SERVICES
Other - Org Name:NETWORK HEALTHCARE FRANKLIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-591-1101
Mailing Address - Street 1:PO BOX 32249
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 SE PARKWAY STE 170
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3962
Practice Address - Country:US
Practice Address - Phone:615-591-1101
Practice Address - Fax:615-435-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTN1173333600000X
TN32893336I0012X
AL2014253336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2092431OtherPK
TN4431932Medicaid
KY54010616Medicaid