Organization
GLENN R BONIFIELD JR
Active
Organization
GLENN R BONIFIELD JR
Active
Other names
MEHR DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN BONIFIELD DPH (OWNER)
(731) 663-2077
Entity
Organization
Contact information
Practice address
131 E MAIN ST, BELLS, TN 38006-4167
(731) 663-2077
(731) 663-2077
Mailing address
PO BOX 280, BELLS, TN 38006-0280
(731) 663-2077
(731) 663-2077
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00000120
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095063
PK
—
Enumeration date
04/03/2007
Last updated
02/03/2016
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