Organization
BLACK BEAR PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LAMB (COMPLIANCE OFFICER)
(770) 474-7693
Entity
Organization
Contact information
Practice address
110 KEITH ST SW STE 1&2, CLEVELAND, TN 37311-5868
(423) 614-6650
Mailing address
106 ROCK QUARRY RD STE B, STOCKBRIDGE, GA 30281-3766
(770) 474-7693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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