Organization
CARESTAR PHARMACY
Active
Other names
CareStar Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP BANNOR (OWNER)
(423) 505-2112
Entity
Organization
Contact information
Practice address
6106 SHALLOWFORD RD STE 108, CHATTANOOGA, TN 37421-2280
(423) 702-5057
(423) 702-5838
Mailing address
PO BOX 22703, CHATTANOOGA, TN 37422-2703
(423) 702-5057
(423) 702-5838
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4782
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4445246
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/23/2012
Last updated
08/23/2012
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