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General NPI Number Information
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NPI Number | 1366785867
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Entity Type | Organization
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Legal Business Name | PARKWEST MEDICAL CENTER
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 220 FORT SANDERS WEST BLVD STE 104
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City | KNOXVILLE
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State | TN
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Zip | 37922-3373
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Country | US
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Telephone | 865-541-4279
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Fax |
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Provider Business Mailing Address
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Address Line | 220 FORT SANDERS WEST BLVD SUITE 104 BLDG 2
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City | KNOXVILLE
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State | TN
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Zip | 37922-3398
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Country | US
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Telephone | 865-541-4279
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CAO
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Name | RICK LASSITER
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Credential |
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Telephone | 865-373-1008
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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 | 5154
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License Number State | TN
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