Organization
TULLAHOMA DRUG STORE INC
Active
Other names
TULLAHOMA DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MCGEE DPH (PRESIDENT)
(931) 455-5409
Entity
Organization
Contact information
Practice address
100 WESTSIDE DR, TULLAHOMA, TN 37388-3253
(931) 455-5409
(931) 455-5469
Mailing address
100 WESTSIDE DR, TULLAHOMA, TN 37388-3253
(931) 455-5409
(931) 455-5469
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1176
TN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454329
—
TN
01
—
2096146
PK
—
Enumeration date
09/29/2006
Last updated
07/19/2018
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