| NPI | 1053405092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY MICHAEL GORDON Pharmacist/Owner 865-691-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-06-10 |