Good Old Drugstore INC
Pharmacy, Community/Retail Pharmacy in Washburn, TN. Organization (NPI-2).
NPI number1790770519
StatusActive
Last updated in NPPESSep 14, 2007
Details
- NPI
- 1790770519
- Entity type
- Organization (NPI-2)
- Legal business name
- Good Old Drugstore INC
- Organization subpart
- No
- Enumeration date
- Sep 19, 2005
- Last updated
- Sep 14, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 4193 | TN | Yes |
| 333600000X | Pharmacy | – | – |
Practice location
8295 Highway 131Washburn, TN 37888
Phone 865-497-9999 · Fax 865-497-9990
Mailing address
Po Box 98Washburn, TN 37888-0098
Authorized official
David Malone
Pic
8654979999
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