# BLOOMINGDALE DRUG OF KINGSPORT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437164316
- **Authorized official:** DR. KENNETH D HARR PHARM. D. (OWNER)
- **Authorized official phone:** (423) 288-4812

## Contact information

- **Practice address:** 2900 BLOOMINGDALE RD, KINGSPORT, TN 37660-1957
- **Practice address phone:** (423) 288-4812
- **Practice address fax:** (423) 288-9469
- **Mailing address:** 2900 BLOOMINGDALE RD, KINGSPORT, TN 37660-1957
- **Mailing address phone:** (423) 288-4812
- **Mailing address fax:** (423) 288-9469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 496 | TN | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 10/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1452212 | — | TN |
| 05 | — | 8508135 | — | VI |