Organization
CATES STREET PHARMACY LLC
Active
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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