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Organization

GREENE VALLEY DEVELOPMENTAL CENTER PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HENRY CROCKETT MEECE PHD (CHIEF OFFICER)
(423) 787-6568
Entity
Organization

Contact information

Practice address
4850 E ANDREW JOHNSON HWY, GREENEVILLE, TN 37745-3098
(423) 378-7665
(423) 787-6776
Mailing address
PO BOX 910, GREENEVILLE, TN 37744-0910
(423) 378-7665
(423) 787-6776

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
711
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4416067
NABP
Enumeration date
11/16/2006
Last updated
11/29/2007
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