Provider Demographics
NPI:1699072058
Name:H&M APOTHECARY LLC
Entity type:Organization
Organization Name:H&M APOTHECARY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHASE
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:731-926-0279
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38310
Mailing Address - Country:US
Mailing Address - Phone:731-632-3278
Mailing Address - Fax:731-632-3279
Practice Address - Street 1:712 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38310
Practice Address - Country:US
Practice Address - Phone:731-632-3278
Practice Address - Fax:731-632-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183500000X, 333600000X
TN48433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4444117OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TN7377310001Medicare NSC