Organization
JOHN DOUGLAS EVANS
Active
Parent organization
JOHN DOUGLAS EVANS
Other names
COMMUNITY DRUG
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN DOUGLAS EVANS
Authorized official
JOHN DOUGLAS EVANS (OWNER)
(615) 855-1603
Entity
Organization
Contact information
Practice address
919 CONFERENCE DR, UNIT 4, GOODLETTSVILLE, TN 37072-1933
(615) 855-1603
(615) 855-1605
Mailing address
PO BOX 1267, GOODLETTSVILLE, TN 37070-1267
(615) 855-1603
(615) 855-1605
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1455058
—
TN
Enumeration date
01/18/2008
Last updated
04/03/2009
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