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Organization

WESLEY T COWAN

Active
Other names
SANITARY DRUG COMPANY
Organization subpart
No

Provider details

NPI number
Authorized official
WESLEY COWAN DPH (PIC AND OWNER)
(865) 674-2526
Entity
Organization

Contact information

Practice address
1627 MAIN ST, WHITE PINE, TN 37890-3302
(865) 674-2526
(865) 674-6739
Mailing address
PO BOX 510, WHITE PINE, TN 37890-0510

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
0000001200
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4411790
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
03/09/2007
Last updated
03/28/2012
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