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NPI Code Detail

MEDICARE: GORDON DRUG COMPANY INC.

MEDICARE: GORDON DRUG COMPANY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesTN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053405092
Entity Type Code : Organization
Provider Name (Legal Business Name) : GORDON DRUG COMPANY INC.
Provider Business Mailing Address
First Line : 7255 OAK RIDGE HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-2614
Country : US
Telephone Number : 865-691-8822
Fax Number : 865-691-7653
Provider Business Practice Location Address
First Line : 7255 OAK RIDGE HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-2614
Country : US
Telephone Number : 865-691-8822
Fax Number : 865-691-7653
Authorized Official
Title or Position : PHARMACIST/OWNER
Name : DR. JERRY MICHAEL GORDON
Credential : DPH
Telephone Number : 865-691-8822
Provider Enumeration Date : 10/03/2006
Last Update Date : 06/10/2013

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Directions to “GORDON DRUG COMPANY INC. ” Practice Location

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