Organization
DAVID N PARK
Active
Other names
DBA PARK PLACE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PARK (OWNER PHARMACIST)
(901) 475-1775
Entity
Organization
Contact information
Practice address
109 W PLEASANT AVE, COVINGTON, TN 38019-2535
(901) 475-1775
(901) 475-6603
Mailing address
109 W PLEASANT AVE, COVINGTON, TN 38019-2535
(901) 475-1775
(901) 475-6603
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4303
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4439647
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
08/22/2020
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