| NPI | 1861407496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE MOORE Owner 423-476-7947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TN 0000000354) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000000354) |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2008-04-20 |