Provider Demographics
NPI:1932571882
Name:T.L.M. CONSULTANT SERVICES, LLC.
Entity Type:Organization
Organization Name:T.L.M. CONSULTANT SERVICES, LLC.
Other - Org Name:TOTAL CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-328-8100
Mailing Address - Street 1:149 E WALTON ST
Mailing Address - Street 2:
Mailing Address - City:BACONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31716-7705
Mailing Address - Country:US
Mailing Address - Phone:229-787-5765
Mailing Address - Fax:229-787-5766
Practice Address - Street 1:149 E WALTON ST
Practice Address - Street 2:
Practice Address - City:BACONTON
Practice Address - State:GA
Practice Address - Zip Code:31716-7705
Practice Address - Country:US
Practice Address - Phone:229-787-5765
Practice Address - Fax:229-787-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0101993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003171649AMedicaid
2155000OtherPK