Organization
MCKENZIE MEDICAL CENTER
Active
Other names
Dresden Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY PHIPPS (CFO)
(731) 352-0820
Entity
Organization
Contact information
Practice address
136 S WILSON ST # B, DRESDEN, TN 38225-1133
(731) 364-4923
(731) 364-4925
Mailing address
205B HOSPITAL DR, MC KENZIE, TN 38201-1649
(731) 352-0820
(731) 352-2848
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4812
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4444218
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/18/2011
Last updated
04/18/2011
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