Healthcare Provider Details

I. General information

NPI: 1497876528
Provider Name (Legal Business Name): STEVEN RAY JOHNSON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5764 HIGHWAY 153
HIXSON TN
37343-3727
US

IV. Provider business mailing address

PO BOX 602
HARRISON TN
37341-0602
US

V. Phone/Fax

Practice location:
  • Phone: 423-870-3267
  • Fax:
Mailing address:
  • Phone: 907-982-0102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1244
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: