Provider Demographics
NPI:1770743114
Name:NOLENSVILLE PHARMACY, INC
Entity type:Organization
Organization Name:NOLENSVILLE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:615-833-1670
Mailing Address - Street 1:7271 NOLENSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9492
Mailing Address - Country:US
Mailing Address - Phone:615-833-1670
Mailing Address - Fax:
Practice Address - Street 1:7271 NOLENSVILLE RD
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9492
Practice Address - Country:US
Practice Address - Phone:615-833-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy