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General NPI Number Information
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NPI Number | 1093324709
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Entity Type | Organization
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Legal Business Name | EAST TN PHARMACIST CONSULTANTS
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 908 W 4TH NORTH ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-3894
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Country | US
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Telephone | 423-618-8805
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Fax |
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Provider Business Mailing Address
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Address Line | 309 LONG BOW RD
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City | KNOXVILLE
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State | TN
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Zip | 37934-1323
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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 | OWNER
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Name | DR. BRADLEY CAGLE
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Credential |
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Telephone | 423-618-8805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number |
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License Number State |
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