Organization
MOONEY'S PHARMACY, INC.
Active
Parent organization
MOONEY'S PHARMACY, INC
Other names
Mooney's Home Medical Equipment
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOONEY'S PHARMACY, INC
Authorized official
MR. THOMAS MOONEY D.PH (OWNER)
(423) 926-3337
Entity
Organization
Contact information
Practice address
1115 N ROAN ST, JOHNSON CITY, TN 37601-3901
(423) 926-3337
Mailing address
1115 N ROAN ST, JOHNSON CITY, TN 37601-3901
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
887
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454962
—
TN
01
—
4134540
BLUE CROSS BLUE SHIELD
TN
Enumeration date
04/06/2007
Last updated
09/01/2015
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