| NPI | 1952715195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL DEBORD Owner 423-581-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 5316) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |