| NPI | 1093975021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE A WILLIFORD Manager 423-899-3930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: TN TN0291) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2008-12-18 |