Organization
MINNIS DRUG STORE INC
Active
Other names
Minnis Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT KENNETH CANTWELL DPH PHARMACY (OWNER CHIEF PHARMICIST)
(423) 586-4562
Entity
Organization
Contact information
Practice address
1250 TENNOVA MEDICAL WAY, KNOXVILLE, TN 37909-3120
(865) 895-6072
Mailing address
PO BOX 369, MORRISTOWN, TN 37815-0369
(423) 586-4562
(423) 587-5537
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
0000001975
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4409670
NABP
TN
Enumeration date
10/23/2006
Last updated
02/28/2023
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