Healthcare Provider Details

I. General information

NPI: 1295811156
Provider Name (Legal Business Name): HOOPER DRUG STORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E. SPRING STREET PO 129
WHITWELL TN
37397-0129
US

IV. Provider business mailing address

PO BOX 129
WHITWELL TN
37397-0129
US

V. Phone/Fax

Practice location:
  • Phone: 423-658-2121
  • Fax: 423-658-7600
Mailing address:
  • Phone: 423-658-2121
  • Fax: 423-658-7600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3581
License Number StateTN

VIII. Authorized Official

Name: JAMES K. HOOPER
Title or Position: PHARMACIST/OWNER
Credential: DPH
Phone: 423-658-2121