Organization
JOHN SMITH PROFESSIONAL PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI S UPCHURCH DPH (PHARMACIST/OWNER)
(931) 484-1434
Entity
Organization
Contact information
Practice address
100 LANTANA RD, STE. 201, CROSSVILLE, TN 38555-1903
(931) 484-1434
(931) 456-2853
Mailing address
100 LANTANA RD, STE. 201, CROSSVILLE, TN 38555-1903
(931) 484-1434
(931) 456-2853
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
60
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3513437
—
TN
01
—
4405797
NABP
TN
Enumeration date
06/07/2006
Last updated
08/22/2020
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