Organization
OLDE TOWNE PHARMACY INC
Active
Other names
OLDE TOWNE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA NOLEN CLOYD (PRESIDENT/PHARMACIST IN CHARGE)
(423) 753-4446
Entity
Organization
Contact information
Practice address
102 W JACKSON BLVD, JONESBOROUGH, TN 37659-1224
(423) 753-4446
(423) 753-4587
Mailing address
102 W JACKSON BLVD, JONESBOROUGH, TN 37659-1224
(423) 753-4446
(423) 753-4587
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1980
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4424367
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
9449461
—
TN
Enumeration date
10/12/2006
Last updated
08/23/2021
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