| NPI | 1760788178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTIE DOUGLAS Payer Relations Manager 615-514-3042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: TN 8108) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2017-06-13 |