Healthcare Provider Details

I. General information

NPI: 1497439715
Provider Name (Legal Business Name): CAREMAX PHARMACY OF LOUDON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 S GAY ST STE 203
KNOXVILLE TN
37902-1142
US

IV. Provider business mailing address

418 S GAY ST STE 203
KNOXVILLE TN
37902-1142
US

V. Phone/Fax

Practice location:
  • Phone: 865-540-1002
  • Fax:
Mailing address:
  • Phone: 865-540-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMY MULDERRY
Title or Position: PRESIDENT
Credential:
Phone: 972-588-1000