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General NPI Number Information
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NPI Number | 1295844413
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Entity Type | Organization
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Legal Business Name | CALDWELLS DRUG STORE INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 511 W MAIN ST
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City | SMITHVILLE
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State | TN
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Zip | 37166
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Country | US
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Telephone | 615-597-1988
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Fax | 615-597-1969
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Provider Business Mailing Address
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Address Line | PO BOX 733
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City | SMITHVILLE
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State | TN
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Zip | 37166-0733
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Country | US
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Telephone | 615-597-1988
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Fax | 615-597-1969
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION OWNER PHAR
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Name | MR. IVAN LYNN CALDWELL
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Credential | PHARMACIST
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Telephone | 615-597-1988
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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 | 1552
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License Number State | TN
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