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Organization

DYER STATION PHARMACY LLC

Active
Other names
Duncan's Express Pharmacy
Organization subpart
No

Provider details

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

Contact information

Practice address
2017 S COLLEGE ST STE B, TRENTON, TN 38382-3934
(731) 855-0500
(731) 855-0400
Mailing address
2017 S COLLEGE ST STE B, TRENTON, TN 38382-3934
(731) 855-0500
(731) 855-0400

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
0000005704
TN
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2155145
PK
05
Q033472
TN
Enumeration date
12/03/2015
Last updated
12/05/2019
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