| NPI | 1447388707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MATTHEW CRAWFORD Owner/ PIC 865-524-3453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TN 2045) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2023-05-25 |