Provider Demographics
NPI:1982615530
Name:GARRETTS PHARMACY INC
Entity type:Organization
Organization Name:GARRETTS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-864-3136
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:BYRDSTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38549-0115
Mailing Address - Country:US
Mailing Address - Phone:931-864-3136
Mailing Address - Fax:888-272-5605
Practice Address - Street 1:8456 HWY ONE ELEVEN
Practice Address - Street 2:
Practice Address - City:BYRDSTOWN
Practice Address - State:TN
Practice Address - Zip Code:38549-6001
Practice Address - Country:US
Practice Address - Phone:931-864-3136
Practice Address - Fax:888-272-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
TN1483336C0003X, 3336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3541083Medicaid
2089342OtherPK
KY54017512Medicaid
KY54017512Medicaid
4418667OtherNABP
0272270001Medicare NSC