Healthcare Provider Details

I. General information

NPI: 1285759902
Provider Name (Legal Business Name): BLOUNTVILLE DRUG COMPANY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 HWY 126
BLOUNTVILLE TN
37617
US

IV. Provider business mailing address

3090 HIGHWAY 126
BLOUNTVILLE TN
37617-4727
US

V. Phone/Fax

Practice location:
  • Phone: 423-323-7711
  • Fax: 423-323-2751
Mailing address:
  • Phone: 423-323-7711
  • Fax: 423-323-2751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2019
License Number StateTN

VIII. Authorized Official

Name: DR. JANE F SNYDER
Title or Position: DIC
Credential: PHD
Phone: 423-323-7711