| NPI | 1962892349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HARTMAN Manager 615-579-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TN 5516) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2016-10-17 |