Provider Demographics
NPI:1467326363
Name:GOOD SHEPHERD PHARMACY LLC
Entity type:Organization
Organization Name:GOOD SHEPHERD PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/ PHARMACY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERVAT
Authorized Official - Middle Name:
Authorized Official - Last Name:FAYEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:615-600-5116
Mailing Address - Street 1:100 FAULKNER LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-2926
Mailing Address - Country:US
Mailing Address - Phone:615-554-7140
Mailing Address - Fax:
Practice Address - Street 1:1550 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3783
Practice Address - Country:US
Practice Address - Phone:615-288-4401
Practice Address - Fax:615-288-4367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD SHEPHERD PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy