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Organization

STATE OF TENNESSEE STATE F & A PAYROLL

Active
Other names
LAKESHORE MENTAL HEALTH INST
Organization subpart
No

Provider details

NPI number
Authorized official
JASON CARTER PHARMD (CHIEF OF PHARMACY)
(615) 532-6736
Entity
Organization

Contact information

Practice address
5908 LYONS VIEW PIKE, KNOXVILLE, TN 37919-7520
(865) 583-8770
(865) 450-5211
Mailing address
5908 LYONS VIEW PIKE, KNOXVILLE, TN 37919-7520
(865) 583-8770
(865) 450-5211

Taxonomy

Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
760
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2088685
PK
Enumeration date
06/13/2006
Last updated
10/14/2014
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