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General NPI Number Information
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NPI Number | 1538565387
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Entity Type | Organization
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Legal Business Name | THE COMPOUNDING PHARMACY OF AMERICA, INC
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 6216 HIGHLAND PLACE WAY SUITE 201
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City | KNOXVILLE
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State | TN
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Zip | 37919-4070
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Country | US
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Telephone | 865-243-2488
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Fax |
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Provider Business Mailing Address
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Address Line | 6216 HIGHLAND PLACE WAY STE 201
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City | KNOXVILLE
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State | TN
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Zip | 37919-4068
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Country | US
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Telephone | 865-243-2488
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DR. VINCENT MATTHEW POTEET
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Credential | PHARMD
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Telephone | 865-243-2488
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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 | 5463
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License Number State | TN
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