Healthcare Provider Details

I. General information

NPI: 1194708503
Provider Name (Legal Business Name): RIGGS DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E CENTRAL AVE
LA FOLLETTE TN
37766-2768
US

IV. Provider business mailing address

PO BOX 1407
LA FOLLETTE TN
37766-1407
US

V. Phone/Fax

Practice location:
  • Phone: 423-562-3160
  • Fax: 423-562-3167
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2215
License Number StateTN

VIII. Authorized Official

Name: ROBERT FANNON
Title or Position: PRES
Credential:
Phone: 423-562-5235