| NPI | 1578099016 |
|---|---|
| Doing Business As | WINDHAM DRUG JELLICO |
| Entity Type | Organization |
| Authorized Contact | JUSTIN SMITH Vice President 423-784-3630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |