Organization
ANDERSON & HAILE DRUG STORE
Active
Other names
Teneal Jenkins
Organization subpart
No
Provider details
NPI number
Authorized official
TENEAL JENKINS PHARMD (OWNER)
(931) 268-0233
Entity
Organization
Contact information
Practice address
101 WEST GORE AVE, GAINESBORO, TN 38562
(931) 268-0233
(931) 268-2183
Mailing address
PO BOX 65, GAINESBORO, TN 38562-0065
(931) 268-0233
(931) 268-2183
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000000378
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4400557
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
4400557
—
TN
Enumeration date
07/25/2006
Last updated
01/29/2019
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