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Organization

BOLIVAR GENERAL HOSPITAL PHARMACY

Active
Other names
Bolivar General Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAURIE YOUNG CRAFT PHARM.D. (PHARMACY DIRECTOR)
(731) 659-0251
Entity
Organization

Contact information

Practice address
650 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-3100
(731) 659-0289
Mailing address
650 NUCKOLLS RD, PO BOX 509, BOLIVAR, TN 38008-1532
(731) 658-3100
(731) 659-0289

Taxonomy

Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
1402
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1402
STATE PHARMACY LICENSE
TN
Enumeration date
02/14/2007
Last updated
08/22/2020
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