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Organization

EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.

Active
Parent organization
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.
Other names
East Tennessee Children's Hospital Outpatient Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION, INC.
Authorized official
MR. STEVEN R GODBOLD (VICE PRESIDENT - OPERATIONS)
(865) 541-8492
Entity
Organization

Contact information

Practice address
2018 CLINCH AVENUE, OUTPATIENT PHARMACY, KNOXVILLE, TN 37916-2301
(865) 541-8980
(865) 541-8429
Mailing address
2018 CLINCH AVENUE, OUTPATIENT PHARMACY, KNOXVILLE, TN 37916-2301
(865) 541-8980
(865) 541-8429

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Q066560
STATE OF TN DEPARTMENT OF HEALTH
TN
Enumeration date
06/09/2021
Last updated
09/12/2024
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