| NPI | 1528635455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN R GODBOLD Vice President Operations 865-541-8492 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-09-12 |