| NPI | 1104001809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BEVINS Owner 423-928-3130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TN 0000003619) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2008-06-05 |