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General NPI Number Information
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NPI Number | 1538342076
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Entity Type | Organization
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Legal Business Name | ROSS ENTERPRISE INC
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 2001 E THIRD ST SUITE C
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2610
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Country | US
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Telephone | 423-648-1040
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Fax | 423-648-3131
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Provider Business Mailing Address
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Address Line | 2001 E 3RD ST STE A
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2610
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Country | US
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Telephone | 423-648-1040
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Fax | 423-648-3131
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. FRED FRANKLIN ROSS III
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Credential | DPH
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Telephone | 423-648-1040
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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 | 6311
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License Number State | TN
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