Organization
NORTHEAST TENNESSEE DISPENSARY OF HOPE PHARMACY
Active
Parent organization
MOUNTAIN STATE HEALTH ALLIANCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNTAIN STATE HEALTH ALLIANCE
Authorized official
DR. JOY WADDELL PHARM-D (PHARMACY SITE MANAGER/PIC)
(423) 431-1570
Entity
Organization
Contact information
Practice address
401A ELM ST, JOHNSON CITY, TN 37601-4601
(423) 431-1570
Mailing address
401A ELM ST, JOHNSON CITY, TN 37601-4601
(423) 431-1570
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
04640
TN
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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