Healthcare Provider Details

I. General information

NPI: 1659408490
Provider Name (Legal Business Name): ROWAN ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 HIGHWAY 93 STE 11
FALL BRANCH TN
37656-1763
US

IV. Provider business mailing address

1714 HIGHWAY 93 STE 11
FALL BRANCH TN
37656-1763
US

V. Phone/Fax

Practice location:
  • Phone: 423-348-6101
  • Fax: 423-348-6716
Mailing address:
  • Phone: 423-348-6101
  • Fax: 423-348-6716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number123
License Number StateTN

VIII. Authorized Official

Name: THOMAS ROWAN
Title or Position: PRESIDENT AND OWNER
Credential:
Phone: 423-283-0911