| NPI | 1629498662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY REBERT Pharmacy Manager 865-305-7420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: TN 5138) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |