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General NPI Number Information
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NPI Number | 1134251671
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Entity Type | Individual
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Provider Name | LEWIS ROGER CASS PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 03/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 121 N HALL RD
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City | ALCOA
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State | TN
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Zip | 37701-2647
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Country | US
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Telephone | 865-977-0349
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Fax |
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Provider Business Mailing Address
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Address Line | 9814 GIVERNY CIR
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City | KNOXVILLE
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State | TN
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Zip | 37922-5885
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Country | US
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Telephone | 865-966-2718
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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 | 1765
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License Number State | TN
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