Healthcare Provider Details
I. General information
NPI: 1447388707
Provider Name (Legal Business Name): MACS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2007
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2419 WASHINGTON PIKE
KNOXVILLE TN
37917-3321
US
IV. Provider business mailing address
2419 WASHINGTON PIKE
KNOXVILLE TN
37917-3321
US
V. Phone/Fax
- Phone: 865-524-3453
- Fax: 865-524-9925
- Phone: 865-524-3453
- Fax: 865-524-9925
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 2045 |
| License Number State | TN |
VIII. Authorized Official
Name:
RICHARD
MATTHEW
CRAWFORD
Title or Position: OWNER/ PIC
Credential:
Phone: 865-524-3453