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General NPI Number Information
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NPI Number | 1245584036
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Entity Type | Organization
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Legal Business Name | VONORE DRUG FAMILY WELLNESS CENTER INC.
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Dates
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Enumeration Date | 11/01/2012
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 1121 HIGHWAY 411
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City | VONORE
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State | TN
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Zip | 37885-2437
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Country | US
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Telephone | 423-884-6274
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Fax | 423-884-6474
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Provider Business Mailing Address
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Address Line | 1121 HIGHWAY 411
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City | VONORE
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State | TN
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Zip | 37885-2437
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Country | US
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Telephone | 423-884-6274
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Fax | 423-884-6474
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | KRISTI L MILLER
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Credential | PHARMD
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Telephone | 423-884-6274
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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 | 5096
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License Number State | TN
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