Organization
OAKLEY PHARMACY INC
Active
Other names
Dale Hollow Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN POLSTON (PIC)
(931) 243-3550
Entity
Organization
Contact information
Practice address
201 MCARTHUR AVE, CELINA, TN 38551-4004
(931) 243-3434
(931) 243-3550
Mailing address
PO BOX 188, CELINA, TN 38551-0188
(931) 243-3434
(931) 243-3550
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0000003817
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130431
PK
—
05
—
6060358
—
TN
Enumeration date
05/26/2011
Last updated
11/30/2016
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