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General NPI Number Information
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NPI Number | 1306283072
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Entity Type | Organization
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Legal Business Name | GUARDIAN PHARMACY OF KNOXVILLE LLC
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 09/30/2016
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Provider Practice Location Address
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Address Line | 431 PARK VILLAGE RD SUITE 105
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City | KNOXVILLE
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State | TN
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Zip | 37923-3849
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Country | US
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Telephone | 865-730-4200
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Fax | 865-730-4201
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Provider Business Mailing Address
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Address Line | GUARDIAN PHARMACY OF TENNESSEE ONE DEPT 2441 P.O. BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-0001
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Country | US
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Telephone | 404-810-0089
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Fax | 404-810-0094
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID BROWN
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Credential |
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Telephone | 931-684-9987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5188
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License Number State | TN
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