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General NPI Number Information
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NPI Number | 1053405092
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Entity Type | Organization
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Legal Business Name | GORDON DRUG COMPANY INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 7255 OAK RIDGE HWY
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City | KNOXVILLE
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State | TN
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Zip | 37931-2614
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Country | US
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Telephone | 865-691-8822
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Fax | 865-691-7653
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Provider Business Mailing Address
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Address Line | 7255 OAK RIDGE HWY
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City | KNOXVILLE
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State | TN
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Zip | 37931-2614
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Country | US
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Telephone | 865-691-8822
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Fax | 865-691-7653
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | DR. JERRY MICHAEL GORDON
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Credential | DPH
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Telephone | 865-691-8822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | TN
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