Individual
DR. MARY CATHERINE MARCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM. D.
Contact information
Practice address
121 E RAVINE RD, SUITE 100, KINGSPORT, TN 37660-3816
(423) 246-6166
(423) 246-9259
Mailing address
121 E RAVINE RD, SUITE 100, KINGSPORT, TN 37660-3816
(423) 246-6166
(423) 246-9259
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000033126
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000033126
TENNESSEE BOARD OF PHARMACY LICENSE
TN
Enumeration date
05/24/2013
Last updated
05/24/2013
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