Healthcare Provider Details

I. General information

NPI: 1871222158
Provider Name (Legal Business Name): UHS SEVIERVILLE PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 MIDDLE CREEK RD STE 180
SEVIERVILLE TN
37862-3051
US

IV. Provider business mailing address

2121 MEDICAL CENTER WAY
KNOXVILLE TN
37920-3290
US

V. Phone/Fax

Practice location:
  • Phone: 865-446-3410
  • Fax: 865-446-3413
Mailing address:
  • Phone: 865-305-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN CUNNINGHAM JR.
Title or Position: SR VICE PRESIDENT & CFO
Credential:
Phone: 865-305-6500