Provider Demographics
NPI:1184654303
Name:PHARMACISTS HOME MEDICAL LLC
Entity type:Organization
Organization Name:PHARMACISTS HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ARMES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:931-836-6387
Mailing Address - Street 1:461 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-1328
Mailing Address - Country:US
Mailing Address - Phone:931-836-6387
Mailing Address - Fax:931-836-1052
Practice Address - Street 1:461 N SPRING ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1328
Practice Address - Country:US
Practice Address - Phone:931-836-6387
Practice Address - Fax:931-836-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332BX2000X332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3125115OtherBLUE CROSS BLUE SHEILD
TN1452524Medicaid
TN3125115OtherTN CARE SELECT
1276380001Medicare ID - Type Unspecified