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Organization
TALLENT DRUG STORE
Active
Organization
TALLENT DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
E. R. DYKES D.PH (PARTNER PHARMACIST)
(423) 442-2400
Entity
Organization
Contact information
Practice address
126 COLLEGE ST, MADISONVILLE, TN 37354-1474
(423) 442-2400
(423) 442-4006
Mailing address
126 COLLEGE ST, MADISONVILLE, TN 37354-1474
(423) 442-2400
(423) 442-4006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
653
TN
332B00000X
Durable Medical Equipment & Medical Supplies
653
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452287
—
TN
Enumeration date
12/16/2006
Last updated
06/17/2008
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