Organization
WILSON PHARMACY INC
Active
Other names
Ballad Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-2140
(423) 431-2144
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 431-2140
(423) 431-2144
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0000004970
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134902
PK
—
Enumeration date
04/24/2012
Last updated
04/18/2024
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