| NPI | 1033512884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALEB THOMAS SELBY Co Owner/Pharmacist 865-692-1603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TN 0000005466) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2020-11-11 |