Organization
J & L STREET INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
KERI SIMERLY (PHARMACY MANAGER)
(423) 741-4231
Entity
Organization
Contact information
Practice address
807 E JACKSON BLVD, JONESBOROUGH, TN 37659-1507
(423) 753-2441
(423) 753-0477
Mailing address
807 E JACKSON BLVD, JONESBOROUGH, TN 37659-1507
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2952
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3698448
—
TN
01
—
4428620
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
03/07/2023
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