Healthcare Provider Details

I. General information

NPI: 1790796340
Provider Name (Legal Business Name): SMITH-TURNER DRUG STORE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 CHURCH ST
SNEEDVILLE TN
37869-3849
US

IV. Provider business mailing address

PO BOX 378
SNEEDVILLE TN
37869-0378
US

V. Phone/Fax

Practice location:
  • Phone: 423-733-2322
  • Fax: 423-733-2140
Mailing address:
  • Phone: 423-733-2322
  • Fax: 423-733-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number54
License Number StateTN

VIII. Authorized Official

Name: KEN SMITH
Title or Position: PRESIDENT
Credential: RPH
Phone: 423-733-2322