| NPI | 1992944631 |
|---|---|
| Doing Business As | MAIN STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ANGELA ROBERTS ETHERIDGE Owner 731-925-6246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TN 4610) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2023-10-02 |