Organization
NEWBERN DISCOUNT DRUG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA B KELLER DPH (OWNER)
(731) 627-9573
Entity
Organization
Contact information
Practice address
625 W MAIN ST STE A, NEWBERN, TN 38059-1573
(731) 627-9573
(731) 627-3051
Mailing address
625 W MAIN ST STE A, NEWBERN, TN 38059-1573
(731) 627-9573
(731) 627-3051
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454269
—
TN
01
—
4418390
NCPDP
TN
Enumeration date
08/24/2006
Last updated
05/17/2011
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