Organization
JASPER DRUGS LLC
Active
Organization
JASPER DRUGS LLC
Active
Other names
JASPER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
FRED STANDEFER (OWNER)
(423) 447-2134
Entity
Organization
Contact information
Practice address
17 COURTHOUSE SQ, JASPER, TN 37347-3531
(423) 942-5636
(423) 942-1354
Mailing address
17 COURTHOUSE SQ, JASPER, TN 37347-3531
(423) 942-5636
(423) 942-1354
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0466
TN
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452478
—
TN
01
—
2095593
PK
—
Enumeration date
02/10/2006
Last updated
12/13/2016
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