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Organization
MIKE SWAIM VAN SWAIM CASEY VERNON
Active
Organization
MIKE SWAIM VAN SWAIM CASEY VERNON
Active
Other names
eastwood pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAC CASEY VERNON DPH (PIC/OWNER)
(731) 642-0451
Entity
Organization
Contact information
Practice address
1325 E WOOD ST, PARIS, TN 38242-4421
(731) 642-0451
(731) 642-4034
Mailing address
1325 E WOOD ST, PARIS, TN 38242-4421
(731) 642-0451
(731) 642-4034
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
311
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452214
—
TN
Enumeration date
02/21/2006
Last updated
04/07/2015
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