Healthcare Provider Details
I. General information
NPI: 1770573677
Provider Name (Legal Business Name): SUMMIT VIEW PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2005
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10703 DUTCHTOWN ROAD
KNOXVILLE TN
37932
US
IV. Provider business mailing address
10703 DUTCHTOWN ROAD
KNOXVILLE TN
37932
US
V. Phone/Fax
- Phone: 865-966-7496
- Fax: 865-675-0412
- Phone: 865-966-7496
- Fax: 865-675-0412
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 00001429 |
| License Number State | TN |
VIII. Authorized Official
Name: DR.
JOAN
MARIE
KYLE
Title or Position: DIRECTOR OF PHARMACY/PIC
Credential: PHARMD.
Phone: 865-966-7496