| NPI | 1821362526 |
|---|---|
| Doing Business As | FOUNTAINRX |
| Doing Business As | FOUNTAIN PLAZA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOSEPH HUNTSMAN Partner & CFO 423-736-7976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: TN 4998) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MO 2018008256) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO OSP.0006973) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054.020619) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MS 14556) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY TN1923) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHNR001097) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 4998) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: TN 4998) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2022-10-05 |