Provider Demographics
NPI:1457543084
Name:HARTSVILLE PHARMACY LLC.
Entity Type:Organization
Organization Name:HARTSVILLE PHARMACY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/PART OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:FOLLIS
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:615-374-4353
Mailing Address - Street 1:207 MCMURRY BLVD E
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-1109
Mailing Address - Country:US
Mailing Address - Phone:615-374-4353
Mailing Address - Fax:615-374-4355
Practice Address - Street 1:207 MCMURRY BLVD E
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1109
Practice Address - Country:US
Practice Address - Phone:615-374-4353
Practice Address - Fax:615-374-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5996680001Medicare NSC