| NPI | 1144358466 |
|---|---|
| Doing Business As | MADISON AVENUE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JEFFRY H WOLFENDEN President 423-746-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 3583) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2023-03-07 |