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General NPI Number Information
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NPI Number | 1033200373
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Entity Type | Individual
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Provider Name | EDWARD SCOTT GRANGER D. PH.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 207 N MAIN ST
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City | SWEETWATER
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State | TN
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Zip | 37874-2806
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Country | US
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Telephone | 423-337-5813
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Fax |
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Provider Business Mailing Address
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Address Line | 1416 AMBLEWINDS CIR
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City | KNOXVILLE
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State | TN
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Zip | 37922-1465
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Country | US
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Telephone | 865-691-3612
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | C-5857
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License Number State | TN
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