Organization
STATE OF TENNESSEE
Active
Other names
East Tennessee Region Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE FANEUIL SHARP (REGIONAL ACCOUNTANT)
(865) 549-5266
Entity
Organization
Contact information
Practice address
810 W CHURCH ST, GREENEVILLE, TN 37745-3285
(423) 798-1749
(423) 798-1755
Mailing address
1522 CHEROKEE TRL, KNOXVILLE, TN 37920-2205
(865) 546-5266
(865) 594-8919
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4440854
NCPDP
TN
Enumeration date
05/10/2007
Last updated
12/14/2007
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