Provider Demographics
NPI:1851631998
Name:LIFE WATCH PHARMACY, LLC
Entity Type:Organization
Organization Name:LIFE WATCH PHARMACY, LLC
Other - Org Name:LIFEWATCH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-823-2322
Mailing Address - Street 1:1 BURTON HILLS BLVD
Mailing Address - Street 2:# 215
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6293
Mailing Address - Country:US
Mailing Address - Phone:615-823-2322
Mailing Address - Fax:
Practice Address - Street 1:211 SUMMIT PARKWAY
Practice Address - Street 2:# 118
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:615-823-2322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL114052333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy