Liberty Drug Store,Inc.

LBN: Liberty Drug Store,Inc.
Liberty Drug Store,Inc. is an health care organization with primary practice located at 1400 N Locust Ave , Lawrenceburg TN 38464-2210. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Liberty Drug Store,Inc. can be contacted via phone (931) 762-6902, or through Evans, Mack A. via phone (931) 762-6902.

Contact Information

Primary practice address
1400 N Locust Ave Lawrenceburg TN 38464-2210
Phone: (931) 762-6902
Fax: (931) 762-1985
Website:
Map and Directions
Authorized official contact:
Name: Evans, Mack A. Doctor of Public Health (DPH)
Phone: (931) 762-6902

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 255 Tennessee

Profile Details

NPI number 1134290075
LBN Legal business name Liberty Drug Store,Inc.
DBA Doing business as
Authorized official Evans, Mack A. Doctor of Public Health (DPH)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2006
Last updated Sep 18th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134290075 NPPES
Tennessee MEDICAID 9441304

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