Healthcare Provider Details

I. General information

NPI: 1578391421
Provider Name (Legal Business Name): MP OPERATING LLC DBA MORRISTOWN PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 W 4TH NORTH ST
MORRISTOWN TN
37814-3814
US

IV. Provider business mailing address

228 N FAIRMONT AVE
MORRISTOWN TN
37814-3768
US

V. Phone/Fax

Practice location:
  • Phone: 423-587-4949
  • Fax:
Mailing address:
  • Phone: 423-586-6263
  • Fax:

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: SARA WALKER
Title or Position: OFFICE MANAGER
Credential:
Phone: 423-586-6263