Provider Demographics
NPI:1992947691
Name:F Z WEBB & SONS PHARMACY OF MCMINNVILLE LLC
Entity type:Organization
Organization Name:F Z WEBB & SONS PHARMACY OF MCMINNVILLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PIC, AO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:931-474-9322
Mailing Address - Street 1:835 SMITHVILLE HWY
Mailing Address - Street 2:STE 25
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-1669
Mailing Address - Country:US
Mailing Address - Phone:931-474-9322
Mailing Address - Fax:931-474-9324
Practice Address - Street 1:835 SMITHVILLE HWY
Practice Address - Street 2:STE 25
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1669
Practice Address - Country:US
Practice Address - Phone:931-474-9322
Practice Address - Fax:931-474-9324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X
TN46313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1517160Medicaid
2119367OtherPK
TN1517160Medicaid