Organization
STATE OF TENNESSEE STATE F & A PAYROLL
Active
Organization
STATE OF TENNESSEE STATE F & A PAYROLL
Active
Other names
MOCCASIN BEND MENTAL HEALTH INST
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CARTER (CHIEF OF PHARMACY)
(615) 532-6736
Entity
Organization
Contact information
Practice address
100 MOCCASIN BEND RD, CHATTANOOGA, TN 37405-4415
(423) 785-3321
(423) 785-3454
Mailing address
100 MOCCASIN BEND RD, CHATTANOOGA, TN 37405-4415
(423) 785-3321
(423) 785-3454
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
L2(16)M21051098
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2088533
PK
—
Enumeration date
06/14/2006
Last updated
10/14/2014
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