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General NPI Number Information
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NPI Number | 1023094802
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Entity Type | Organization
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Legal Business Name | SABRA C RINIO
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 425 N SPRING ST
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City | SPARTA
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State | TN
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Zip | 38583-1323
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Country | US
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Telephone | 931-836-2414
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Fax | 931-836-3950
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Provider Business Mailing Address
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Address Line | 425 N SPRING ST
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City | SPARTA
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State | TN
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Zip | 38583-1323
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Country | US
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Telephone | 931-836-2414
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Fax | 931-836-3950
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | SABRA C RINIO
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Credential | RPH
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Telephone | 931-836-2414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 325
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License Number State | TN
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