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Organization

SOUTHERRN HOME INFUSION PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WESLEY TAYLOR COWAN D.PH (CHIEF PHARMACIST)
(865) 674-6700
Entity
Organization

Contact information

Practice address
1721 MAIN STREET, WHITE PINE, TN 37890
(865) 674-6700
(865) 674-6704
Mailing address
PO BOX 670, 1721 MAIN STREET, WHITE PINE, TN 37890
(865) 674-6700
(865) 674-6704

Taxonomy

Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
2342
TN

Other

Enumeration date
05/13/2008
Last updated
05/13/2008
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