Organization Name: | SULLIVAN COUNTY HEALTH DEPARTMENT PHARMACY |
NPI Number: | 1801082664 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY MAYES (REGIONAL DIRECTOR) |
Mailing Address: | 154 Blountville Byp Blountville |
State: | TN US |
Postal Code: | 376174575 |
Phone Number: | 4232792777 |
Fax Number: | 4232792797 |
NPI Enumeration Date: | 09/14/2007 |
NPI Last Update Date: | 09/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |