Organization
TRITENN LLC
Active
Other names
Gray Pharmacy, Tri-Cities Pharmacy of Gray
Organization subpart
No
Provider details
NPI number
Authorized official
JORDON THOMAS BAKER PHARM D. (CEO / CO-OWNER)
(423) 772-3591
Entity
Organization
Contact information
Practice address
208 SUNCREST ST, STE 1, GRAY, TN 37615-3494
(423) 477-3847
(423) 477-4392
Mailing address
208 SUNCREST ST UNIT 1, JOHNSON CITY, TN 37615-3494
(423) 477-3847
(423) 477-4392
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
C001007
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149630001
—
TN
05
—
3539406
—
TN
Enumeration date
10/06/2006
Last updated
04/30/2026
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