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General NPI Number Information
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NPI Number | 1477697589
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Entity Type | Organization
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Legal Business Name | FOUR WAY PRESCRIPTION SHOP
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 8707A ASHEVILLE HWY
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City | KNOXVILLE
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State | TN
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Zip | 37924-4502
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Country | US
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Telephone | 865-933-2451
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Fax | 865-932-1838
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Provider Business Mailing Address
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Address Line | 8707A ASHEVILLE HWY
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City | KNOXVILLE
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State | TN
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Zip | 37924-4502
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Country | US
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Telephone | 865-933-2451
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Fax | 865-932-1838
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Authorized Official
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Title or Position | OWNER
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Name | MR. BEN C LOTT
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Credential | DPH
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Telephone | 865-933-2451
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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 |
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License Number State |
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