Organization
EAST END PHARMACY INC
Active
Other names
East End Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK AILEY (PIC)
(423) 289-1755
Entity
Organization
Contact information
Practice address
5630 E ANDREW JOHNSON HWY, RUSSELLVILLE, TN 37860-9416
(423) 289-1755
(423) 289-1757
Mailing address
PO BOX 390, RUSSELLVILLE, TN 37860-0390
(423) 289-1755
(423) 289-1757
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000005106
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137870
PK
—
Enumeration date
11/07/2012
Last updated
07/19/2018
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