Organization
STANDEFER PHARMACY
Active
Other names
STANDEFER DRUGCENTER
Organization subpart
No
Provider details
NPI number
Authorized official
FRED STANDEFER (PARTNER AND PHARMACIST)
(423) 447-2134
Entity
Organization
Contact information
Practice address
3051 MAIN ST, PIKEVILLE, TN 37367-0150
(423) 447-2134
(423) 447-6330
Mailing address
PO BOX 150, PIKEVILLE, TN 37367-0150
(423) 447-2134
(423) 447-6330
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1069
TN
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095984
PK
—
05
—
3513097
—
TN
Enumeration date
12/05/2006
Last updated
05/20/2016
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