Healthcare Provider Details
I. General information
NPI: 1689611493
Provider Name (Legal Business Name): CLEVELAND WORX LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2006
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1525 25TH ST NW
CLEVELAND TN
37311
US
IV. Provider business mailing address
1525 25TH ST NW
CLEVELAND TN
37311
US
V. Phone/Fax
- Phone: 423-559-3000
- Fax: 423-559-3007
- Phone: 423-559-3000
- Fax: 423-559-3007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 24 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 24 |
| License Number State | TN |
VIII. Authorized Official
Name:
CHAD
SMITH
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 423-559-3000