Organization
LIFE WELL PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP BLAKE MUSICK PHARMD (MEMBER)
(276) 591-7035
Entity
Organization
Contact information
Practice address
2408 SUSANNAH ST STE 3, JOHNSON CITY, TN 37601-1765
(423) 202-7870
(423) 268-2011
Mailing address
288 LAUREL CYN, JOHNSON CITY, TN 37615-4726
(276) 591-7035
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
08/06/2021
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