Organization
RIGGS DRUG STORE
Active
Other names
Riggs Drug Jacksboro
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FANNON (OWNER)
(423) 562-5235
Entity
Organization
Contact information
Practice address
2636 JACKSBORO PIKE, JACKSBORO, TN 37757
(423) 566-1967
(423) 566-1797
Mailing address
PO BOX 100, JACKSBORO, TN 37757-0100
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3585
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3518937
—
TN
01
—
4434647
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/21/2006
Last updated
11/25/2008
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