Organization
EAST TENNESSEE STATE UNIVERSITY
Active
Other names
ETSU Charitable Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID D COLLINS (CFO, VP FINANCE ADMIN)
(423) 439-5884
Entity
Organization
Contact information
Practice address
2151 CENTURY LN, JOHNSON CITY, TN 37604-4469
(423) 926-2500
(423) 926-5999
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4071
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
5399
TN
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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