| NPI | 1073078481 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2019-02-10 |
| Last Updated | 2019-08-02 |
| Authorized Official | Elizabeth Willis Owner/Pharmacist-in-Charge Phone: 7314721011 |
| Mailing Address | 1355 W Market St Bolivar, TN 38008-1715 United States Phone: (731) 472-1011 | Fax: (423) 661-7602 📍 View Map |
| Primary Practice Address | 1355 W Market St Bolivar, TN 38008-1715 United States Phone: (731) 472-1011 | Fax: (423) 661-7602 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | TN | 00006619 | TN Board of Pharmacy License Number |
| MEDICAID | TN | Q048235 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 333600000X – Pharmacy | - | - |
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About NPI 1073078481
Southern Express Pharmacy is an organization registered in the CMS NPPES NPI Registry with NPI number 1073078481. The primary specialty listed is Pharmacy. The organization is located in Bolivar, TN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2019-02-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073078481?
NPI 1073078481 belongs to Southern Express Pharmacy, a Pharmacy in Bolivar, TN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073078481 active?
The current status of NPI 1073078481 in the NPPES registry is Active. The record was last updated on 2019-08-02.
What specialty is NPI 1073078481?
NPI 1073078481 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073078481?
You can verify NPI 1073078481 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073078481?
The primary practice address on file for NPI 1073078481 is 1355 W Market St, Bolivar, TN 38008-1715. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073078481 issued?
NPI 1073078481 was first issued (enumerated) on 2019-02-10. The NPPES record was last updated on 2019-08-02.
Practice Location Map
Southern Express Pharmacy is located at 1355 W Market St, Bolivar, TN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Southern Express Pharmacy. All records sourced from the CMS NPPES registry.