| NPI | 1568673036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE SHAVER Director Of Reimbursement 423-778-4712 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 3677) |
| Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy (Licence: NC 3677) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: NC 3677) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2023-03-07 |