Organization
EDDIES DRUG STORE LLC
Active
Organization
EDDIES DRUG STORE LLC
Active
Other names
Eddie's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE LEWIS (OWNER/PHARMACIST IN CHARGE)
(865) 286-9079
Entity
Organization
Contact information
Practice address
1240 FOX MEADOWS BLVD STE 3, SEVIERVILLE, TN 37862-6928
(865) 286-9079
(865) 286-9016
Mailing address
1240 FOX MEADOWS BLVD, STE #3, SEVIERVILLE, TN 37862-6928
(865) 286-9079
(865) 286-9016
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5003
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4444953
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/25/2012
Last updated
07/17/2012
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