Healthcare Provider Details

I. General information

NPI: 1003950742
Provider Name (Legal Business Name): ALAMO-CITY DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N CAVALIER DR
ALAMO TN
38001-6468
US

IV. Provider business mailing address

8 N CAVALIER DR
ALAMO TN
38001-6468
US

V. Phone/Fax

Practice location:
  • Phone: 731-696-2266
  • Fax: 731-696-2204
Mailing address:
  • Phone: 731-696-2266
  • Fax: 731-696-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number1231
License Number StateTN

VIII. Authorized Official

Name: MELVIN ROY YORK
Title or Position: OWNER-PHARMAACIST
Credential:
Phone: 731-696-2266