| NPI | 1700955861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE RENFRO Owner 423-926-9137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TN 404) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2015-08-27 |