Healthcare Provider Details

I. General information

NPI: 1881756658
Provider Name (Legal Business Name): THE FAMILY WELLNESS GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 VETERANS MEMORIAL DR
TELLICO PLAINS TN
37385-4844
US

IV. Provider business mailing address

707 VETERANS MEMORIAL DRIVE
TELLICO PLAINS TN
37385
US

V. Phone/Fax

Practice location:
  • Phone: 423-253-6003
  • Fax: 423-253-6888
Mailing address:
  • Phone: 423-253-6003
  • Fax: 423-253-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number4285
License Number StateTN

VIII. Authorized Official

Name: DR. JASON CARL MILLER
Title or Position: PHARMACIST
Credential: PHARM D.
Phone: 423-253-6003