| NPI | 1023393543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY ANN LUCAS Pharmacist 865-908-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: TN 35747) |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2011-10-16 |