Provider Demographics
NPI:1194261651
Name:DURHURST CLINICAL SERVICES, LLC
Entity type:Organization
Organization Name:DURHURST CLINICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, PIC
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:931-295-3406
Mailing Address - Street 1:110 KITTRELL ST
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-1363
Mailing Address - Country:US
Mailing Address - Phone:931-295-3406
Mailing Address - Fax:931-295-3408
Practice Address - Street 1:110 KITTRELL ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-1363
Practice Address - Country:US
Practice Address - Phone:731-926-5001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DURHURST CLINICAL SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN59363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy