Organization
GUARDIAN PHARMACY OF KNOXVILLE LLC
Active
Other names
East Tennessee Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BROWN (PRESIDENT)
(931) 684-9987
Entity
Organization
Contact information
Practice address
431 PARK VILLAGE RD, SUITE 105, KNOXVILLE, TN 37923-3849
(865) 730-4200
(865) 730-4201
Mailing address
GUARDIAN PHARMACY OF TENNESSEE ONE DEPT 2441, P.O. BOX 11407, BIRMINGHAM, AL 35246-0001
(404) 810-0089
(404) 810-0094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
5188
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306283072
—
AL
05
—
1306283072
—
NV
05
—
1306283072
—
TN
05
—
1306283072
—
VA
05
—
142751200
—
WY
05
—
200642900A
—
OK
01
—
2140656
PK
—
05
—
3810030160
—
WV
05
—
70100257410
—
KY
05
—
7T5188
—
SC
Enumeration date
06/04/2013
Last updated
09/30/2016
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