Provider Demographics
NPI:1881828200
Name:AMERICARE PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:AMERICARE PHARMACY SERVICES LLC
Other - Org Name:PEGASUS EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST, GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-528-0070
Mailing Address - Street 1:621 E 15TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1875
Mailing Address - Country:US
Mailing Address - Phone:931-528-0080
Mailing Address - Fax:866-471-1114
Practice Address - Street 1:621 E 15TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-1875
Practice Address - Country:US
Practice Address - Phone:931-528-0070
Practice Address - Fax:866-471-1114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICARE PHARMACY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-13
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46423336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy