Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Portland Prescription Shop PLLC

Organization Internal Medicine Physician · NPI 1043612880

Portland Prescription Shop PLLC is an Internal Medicine Physician in Portland, Tennessee. Licensed in Tennessee. Registered with an NPI since 2014.

Licensed in
TN
In the registry since
2014
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

705 S Broadway St
Portland, TN 37148-1628
Phone: (615) 323-5050
Fax: (615) 323-5052
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Community/Retail Pharmacy Taxonomy 3336C0003X · Licence 5451 (TN)

Record details

NPI number1043612880
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Stinnett — Ceo · (270) 392-4248
NPI enumeratedSeptember 24, 2014
Last updated in NPPESAugust 24, 2023
Certification dateAugust 24, 2023
Mailing address705 S Broadway St, P.O. Box 910, Portland, TN 37148-1628

Other providers in Portland