Organization
CAVALIER PHARMACY LLC
Active
Other names
Cavalier Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK HOLYFIELD PHARM. D (MANAGING MEMBER)
(731) 692-3578
Entity
Organization
Contact information
Practice address
8 N CAVALIER DR, SUITE A, ALAMO, TN 38001-6468
(731) 696-4000
(731) 696-4050
Mailing address
8 N CAVALIER DR, SUITE A, ALAMO, TN 38001-6468
(731) 696-4000
(731) 696-4050
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4823
TN
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127327
PK
—
Enumeration date
11/09/2010
Last updated
03/31/2023
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