Healthcare Provider Details

I. General information

NPI: 1013075514
Provider Name (Legal Business Name): HOMEBIOTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/07/2023
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19118 ALBERTA ST
ONEIDA TN
37841-6003
US

IV. Provider business mailing address

19118 ALBERTA ST
ONEIDA TN
37841-6003
US

V. Phone/Fax

Practice location:
  • Phone: 423-569-2400
  • Fax: 423-569-2402
Mailing address:
  • Phone: 423-569-2400
  • Fax: 423-569-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2315
License Number StateTN

VIII. Authorized Official

Name: TERRY ROARK
Title or Position: PHARMACIST
Credential: DPH
Phone: 423-569-2400