Healthcare Provider Details

I. General information

NPI: 1457457533
Provider Name (Legal Business Name): R & K PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/07/2023
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 WEST OCOEE STREET
COPPERHILL TN
37317-0370
US

IV. Provider business mailing address

PO BOX 370
COPPERHILL TN
37317-0370
US

V. Phone/Fax

Practice location:
  • Phone: 423-496-5241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9457
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAD SMITH
Title or Position: PHARMACIST/ PHARMACY MANAGER
Credential:
Phone: 423-496-5241