Provider Demographics
NPI:1699283598
Name:PRESCRIPTION SHOPPE LLC
Entity type:Organization
Organization Name:PRESCRIPTION SHOPPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-581-0930
Mailing Address - Street 1:300 WINDHAVEN BAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-6913
Mailing Address - Country:US
Mailing Address - Phone:615-581-0930
Mailing Address - Fax:615-581-0933
Practice Address - Street 1:614A HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9354
Practice Address - Country:US
Practice Address - Phone:615-218-5895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-14
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy