Organization
MED CENTER PHARMACY LLC
Active
Other names
MED CENTER PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PACK (OWNER AND PHARMACIST)
(423) 272-8104
Entity
Organization
Contact information
Practice address
900 W MAIN ST, ROGERSVILLE, TN 37857-2448
(423) 272-8104
(423) 272-0282
Mailing address
900 W MAIN ST, ROGERSVILLE, TN 37857-2448
(423) 272-8104
(423) 272-0282
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1706
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095045
PK
—
Enumeration date
09/30/2006
Last updated
02/16/2015
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