Healthcare Provider Details

I. General information

NPI: 1427747492
Provider Name (Legal Business Name): MACS PHARMACY AT SOUTH PETERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S PETERS RD
KNOXVILLE TN
37923-5202
US

IV. Provider business mailing address

125 S PETERS RD
KNOXVILLE TN
37923-5202
US

V. Phone/Fax

Practice location:
  • Phone: 865-381-2500
  • Fax: 855-571-3531
Mailing address:
  • Phone: 865-381-2500
  • Fax: 855-571-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD MATTHEW CRAWFORD
Title or Position: PRESIDENT
Credential:
Phone: 865-524-3453