Organization
KMART PHARMACY 3022
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES EDWIN ROBERTS II PHARM.D (PHARMACIST)
(423) 968-7032
Entity
Organization
Contact information
Practice address
2854 W STATE ST, BRISTOL, TN 37620-1711
(423) 968-7032
(847) 396-2508
Mailing address
2854 W STATE ST, BRISTOL, TN 37620-1711
(423) 968-7032
(847) 396-2508
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36205
TN
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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