| NPI | 1912900663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A REED Pharmacist 423-282-1178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TN 1751) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2015-11-13 |