| NPI | 1841363165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH ANDES MCDANIEL Owner 865-584-8551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: TN DPO0000000746) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-02-08 |