| NPI | 1760717896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL MARTIN Chief Manager Physician 865-637-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TN 4721) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2016-06-21 |