Provider Demographics
NPI:1629186044
Name:COMMUNITY PHARMACY CARE INC
Entity type:Organization
Organization Name:COMMUNITY PHARMACY CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:H
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:615-446-8043
Mailing Address - Street 1:127 CRESTVIEW PARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2854
Mailing Address - Country:US
Mailing Address - Phone:615-446-8043
Mailing Address - Fax:615-446-7556
Practice Address - Street 1:127 CRESTVIEW PARK DR
Practice Address - Street 2:STE 100
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2854
Practice Address - Country:US
Practice Address - Phone:615-446-8043
Practice Address - Fax:615-446-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6021370002Medicare NSC