| NPI | 1164563896 |
|---|---|
| Doing Business As | LA VERGNE DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | JERRY ELEDGE President 615-213-1203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TN 3988) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-11-29 |