Provider Demographics
NPI:1831349646
Name:PHARMEDIUM SERVCIES LLC
Entity type:Organization
Organization Name:PHARMEDIUM SERVCIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-547-3929
Mailing Address - Street 1:6100 GLOBAL DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38141-8385
Mailing Address - Country:US
Mailing Address - Phone:901-547-3900
Mailing Address - Fax:901-367-6896
Practice Address - Street 1:6100 GLOBAL DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-8385
Practice Address - Country:US
Practice Address - Phone:901-547-3900
Practice Address - Fax:901-367-6896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4441654OtherNCPDP PROVIDER IDENTIFICATION NUMBER