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Organization

STATE OF TENNESSEE

Active
Other names
Southeast TN Reg Public Health Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JUDY K SHAW (ACCOUNTANT 3)
(423) 634-5832
Entity
Organization

Contact information

Practice address
540 MCCALLIE AVE, SUITE 450, CHATTANOOGA, TN 37402-2089
(423) 634-3124
Mailing address
540 MCCALLIE AVE, SUITE 450, CHATTANOOGA, TN 37402-2089
(423) 634-3124

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Enumeration date
04/30/2007
Last updated
08/22/2020
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