Healthcare Provider Details

I. General information

NPI: 1134270143
Provider Name (Legal Business Name): UNITED APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 E TRI COUNTY BLVD
OLIVER SPRINGS TN
37840-5413
US

IV. Provider business mailing address

PO BOX 5688
OAK RIDGE TN
37831-5688
US

V. Phone/Fax

Practice location:
  • Phone: 865-435-3333
  • Fax: 865-435-2194
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberC3292
License Number StateTN

VIII. Authorized Official

Name: GEORGE RIDDLE
Title or Position: PHARMACIST AND OWNER
Credential:
Phone: 865-435-3333