| NPI | 1467527473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY R FERGUSON Co Owner 865-453-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: TN DPO0000000400) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |