Provider Demographics
NPI:1205968989
Name:ARLINGTON DEVELOPMENTAL CENTER PHARMACY
Entity type:Organization
Organization Name:ARLINGTON DEVELOPMENTAL CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:901-745-7232
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:11293 MEMPHIS-ARLINGTON RD
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-0586
Mailing Address - Country:US
Mailing Address - Phone:901-745-7232
Mailing Address - Fax:901-745-7276
Practice Address - Street 1:11293 MEMPHIS ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-7978
Practice Address - Country:US
Practice Address - Phone:901-745-7232
Practice Address - Fax:901-745-7276
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF TENNESSEE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-09
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10373336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4404303OtherNCPDP NUMBER