Healthcare Provider Details

I. General information

NPI: 1689125106
Provider Name (Legal Business Name): SNAPPS FERRY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 SNAPPS FERRY RD
GREENEVILLE TN
37745-4029
US

IV. Provider business mailing address

PO BOX 874
GREENEVILLE TN
37744-0874
US

V. Phone/Fax

Practice location:
  • Phone: 423-638-7552
  • Fax: 423-638-2552
Mailing address:
  • Phone: 423-638-7552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1109
License Number StateTN

VIII. Authorized Official

Name: ALAN CORLEY
Title or Position: PRESIDENT
Credential:
Phone: 423-630-7030