Organization
DISNEY PHARMACY SERVICES INC
Active
Other names
VAUGHN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT DISNEY RPH (OWNER,PIC,AO)
(865) 947-1581
Entity
Organization
Contact information
Practice address
2141 W EMORY RD, POWELL, TN 37849-3704
(865) 947-1581
(865) 947-4353
Mailing address
2141 W EMORY RD, POWELL, TN 37849-3704
(865) 947-1581
(865) 947-4353
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1945
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090600
PK
—
Enumeration date
11/08/2006
Last updated
06/27/2015
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