Provider Demographics
NPI:1356351902
Name:C & M PHARMACY INC.
Entity type:Organization
Organization Name:C & M PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:SR
Authorized Official - Phone:931-762-7141
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-0486
Mailing Address - Country:US
Mailing Address - Phone:931-762-7141
Mailing Address - Fax:931-766-0086
Practice Address - Street 1:717 N MILITARY AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2626
Practice Address - Country:US
Practice Address - Phone:931-762-7141
Practice Address - Fax:931-766-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000005233336C0003X
TN00000035473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356351902OtherFIRST HEALTH
TN3513345Medicaid
1356351902OtherCAREMARK
1356351902OtherPCS
1356351902OtherPCS