Organization
CATES STREET PHARMACY LLC
Active
Other names
CATES STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB STANDEFER (MANAGER)
(423) 877-3568
Entity
Organization
Contact information
Practice address
104 CATES ST, DUNLAP, TN 37327-6093
(423) 949-5722
(423) 949-6176
Mailing address
PO BOX 1685, DUNLAP, TN 37327-1685
(423) 949-5722
(423) 949-6176
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00003967
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2094085
PK
—
05
—
Q047238
—
TN
Enumeration date
02/13/2006
Last updated
09/02/2025
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