Organization
WEST TOWNE PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE RENFRO (OWNER)
(423) 926-9137
Entity
Organization
Contact information
Practice address
1619 W MARKET ST, JOHNSON CITY, TN 37604-6018
(423) 926-9137
(423) 926-7321
Mailing address
1619 W MARKET ST, JOHNSON CITY, TN 37604-6018
(423) 926-9137
(423) 926-7321
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
404
TN
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4418174
—
TN
Enumeration date
11/06/2006
Last updated
08/27/2015
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