Healthcare Provider Details

I. General information

NPI: 1255342804
Provider Name (Legal Business Name): QUALITY DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 N WASHINGTON AVE
BROWNSVILLE TN
38012-1607
US

IV. Provider business mailing address

2288 N WASHINGTON AVE
BROWNSVILLE TN
38012-1607
US

V. Phone/Fax

Practice location:
  • Phone: 731-772-2012
  • Fax: 731-772-9841
Mailing address:
  • Phone: 731-772-2012
  • Fax: 731-772-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberTN144
License Number StateTN

VIII. Authorized Official

Name: GARY PETTIGREW
Title or Position: OWNER
Credential: DPH
Phone: 731-772-2012