Organization
CCD OPERATING LLC DBA CRESCENT CENTER DRUGS
Active
Other names
CRESCENT CENTER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RYAN KRAGEL PHARM D (OWNER/PHARMACIST)
(423) 586-6263
Entity
Organization
Contact information
Practice address
228 NORTH FAIRMONT AVAE, MORRISTOWN, TN 37814
(423) 586-6263
(423) 587-5460
Mailing address
228 NORTH FAIRMONT AVAE, MORRISTOWN, TN 37814
(423) 586-6263
(423) 587-5460
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
703
TN
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095811
PK
—
05
—
3564207
—
TN
Enumeration date
08/10/2006
Last updated
03/06/2019
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