Organization
ROBERT D MITCHELL
Active
Other names
SELMER DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MITCHELL DPH (OWNER)
(731) 645-5591
Entity
Organization
Contact information
Practice address
133 W COURT AVE, SELMER, TN 38375-2130
(731) 645-5391
(731) 645-5391
Mailing address
133 W COURT AVE, SELMER, TN 38375-2130
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1107
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2096004
PK
—
05
—
3519165
—
TN
Enumeration date
12/28/2006
Last updated
04/25/2013
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