Organization
STATE OF TENNESSEE
Active
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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