Organization
PROCOMPOUNDING
Active
Other names
Procompounding pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PATRONE PHARM.D. (PHARMACIST/OWNER)
(423) 975-0597
Entity
Organization
Contact information
Practice address
527 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-8210
(423) 975-0597
(423) 975-6304
Mailing address
527 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-8210
(423) 975-0597
(423) 975-6304
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
QO32940
—
TN
Enumeration date
11/05/2021
Last updated
02/25/2022
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