Organization
MIKE SWAIM VAN SWAIM CASEY VERNON
Active
Other names
eastwood pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAC CASEY VERNON DPH (PIC/OWNER)
(731) 642-0451
Entity
Organization
Contact information
Practice address
1325 E WOOD ST, PARIS, TN 38242-4421
(731) 642-0451
(731) 642-4034
Mailing address
1325 E WOOD ST, PARIS, TN 38242-4421
(731) 642-0451
(731) 642-4034
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
311
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452214
—
TN
Enumeration date
02/21/2006
Last updated
04/07/2015
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