Organization
EAST TENNESSEE HEMATOLOGY-ONCOLOGY ASSOC
Active
Organization
EAST TENNESSEE HEMATOLOGY-ONCOLOGY ASSOC
Active
Other names
McLeod Cancer and Blood Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COMBS (ADMINISTRATOR)
(423) 461-7867
Entity
Organization
Contact information
Practice address
302 WESLEY ST STE 3, JOHNSON CITY, TN 37601-1741
(423) 631-0523
(423) 631-0522
Mailing address
310 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6008
(423) 926-3611
(423) 926-3073
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4926
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4444674
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/02/2011
Last updated
12/02/2011
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