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Organization

DYER STATION PHARMACY, LLC

Active
Other names
Duncan's Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEREK HOLYFIELD PHARM. D (MANAGING PARTNER)
(731) 692-3578
Entity
Organization

Contact information

Practice address
137 S MAIN ST, DYER, TN 38330-1815
(731) 692-3578
(731) 692-4219
Mailing address
PO BOX 265, DYER, TN 38330-0265
(731) 692-3578
(731) 692-4219

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
2878
TN
3336C0003X
Community/Retail Pharmacy
Primary
2878
TN
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1454681
TN
Enumeration date
11/22/2005
Last updated
11/13/2021
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