Organization
MEDICAL MALL PHARMACY INC
Active
Other names
MEDICAL MALL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE HAGEE (PHARMACY SYSTEMS ANALYST)
(423) 230-8432
Entity
Organization
Contact information
Practice address
1 MEDICAL PARK BLVD, SUITE 106-E, BRISTOL, TN 37620-7430
(423) 844-2888
(423) 844-2891
Mailing address
1 MEDICAL PARK BLVD STE 106, BRISTOL, TN 37620-7430
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2964
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008503257
—
TN
01
—
4428719
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/23/2005
Last updated
04/30/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us