Healthcare Provider Details

I. General information

NPI: 1811030331
Provider Name (Legal Business Name): CAREMAX PHARMACY OF LOUDON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 S GAY ST STE 203
KNOXVILLE TN
37902-1104
US

IV. Provider business mailing address

17111 PRESTON RD STE 100
DALLAS TX
75248-1234
US

V. Phone/Fax

Practice location:
  • Phone: 865-540-1002
  • Fax: 866-491-5888
Mailing address:
  • Phone: 866-972-5888
  • Fax: 664-915-8888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number830
License Number StateTN

VIII. Authorized Official

Name: AMY MULDERRY
Title or Position: PRESIDENT
Credential:
Phone: 972-588-1050