Organization
STANIFER PHARMACY LLC
Active
Other names
Stanifer Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL ESSARY (PHARMACIST/OWNER)
(423) 626-7337
Entity
Organization
Contact information
Practice address
420 N BROAD ST, NEW TAZEWELL, TN 37825-6606
(423) 626-7337
(423) 626-0189
Mailing address
PO BOX 1438, NEW TAZEWELL, TN 37824-1438
(423) 626-7337
(423) 626-0189
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4057
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454670
—
TN
01
—
2159557
PK
—
Enumeration date
12/04/2006
Last updated
03/27/2017
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