Organization
HILLCREST DRUG STORE INC
Active
Other names
HILLCREST DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG AUSTIN (PIC)
(423) 926-0084
Entity
Organization
Contact information
Practice address
714 W MARKET ST STE 103, JOHNSON CITY, TN 37604-5483
(423) 926-6231
(423) 926-0084
Mailing address
714 W MARKET ST STE 103, JOHNSON CITY, TN 37604-5483
(423) 926-6231
(423) 926-0084
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0477
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095599
PK
—
05
—
3551938
—
TN
Enumeration date
07/30/2006
Last updated
12/22/2016
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