| NPI | 1881609485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY GORDAN Pharmacist 865-693-1025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TN 4232) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2014-10-07 |