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General NPI Number Information
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NPI Number | 1073986022
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Entity Type | Organization
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Legal Business Name | VALUE RX III LLC
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 11/21/2016
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Provider Practice Location Address
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Address Line | 6161 W ANDREW JOHNSON HWY
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City | TALBOTT
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State | TN
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Zip | 37877-8603
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Country | US
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Telephone | 423-839-1663
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Fax | 423-839-2097
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Provider Business Mailing Address
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Address Line | 6161 W ANDREW JOHNSON HWY
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City | TALBOTT
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State | TN
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Zip | 37877-8603
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Country | US
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Telephone | 423-839-1663
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Fax | 423-839-2097
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | MR. ALLEN SMITH
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Credential | RPH
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Telephone | 423-839-1663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0000005685
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License Number State | TN
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