Organization
BISE, PLLC
Active
Other names
Surgoinsville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH A BRYAN PHARMD (OWNER/PHARMACIST)
(423) 345-0333
Entity
Organization
Contact information
Practice address
114 BELLAMY AVENUE, SURGOINSVILLE, TN 37873
(423) 345-0333
(423) 345-0336
Mailing address
P.O. BOX 105, SURGOINSVILLE, TN 37873
(423) 345-0333
(423) 345-0336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4442694
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
Q045913
—
TN
Enumeration date
07/27/2009
Last updated
03/24/2025
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