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General NPI Number Information
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NPI Number | 1063008126
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Entity Type | Organization
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Legal Business Name | DOCS HOMETOWN PHARMACY LLC
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Dates
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Enumeration Date | 12/14/2020
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 951 HIGHWAY 51 N
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City | COVINGTON
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State | TN
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Zip | 38019-1702
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Country | US
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Telephone | 901-581-2032
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Fax |
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Provider Business Mailing Address
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Address Line | 2283 CANDY LN
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City | BURLISON
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State | TN
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Zip | 38015-7331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. BRENT E. SMITH
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Credential | DPH
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Telephone | 901-581-2032
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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 |
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License Number State |
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