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General NPI Number Information
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NPI Number | 1598152498
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Entity Type | Organization
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Legal Business Name | CAREMAX COMMUNITY PHARMACY LLC
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 418 S GAY ST STE 104
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City | KNOXVILLE
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State | TN
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Zip | 37902-1134
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Country | US
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Telephone | 865-692-1603
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Fax | 865-692-1604
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Provider Business Mailing Address
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Address Line | 418 S GAY ST STE 104
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City | KNOXVILLE
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State | TN
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Zip | 37902-1134
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Country | US
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Telephone | 865-692-1603
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Fax | 865-692-1604
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Authorized Official
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Title or Position | CO-OWNER/PHARMACIST
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Name | CALEB MARCUM SELBY
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Credential | PHARMD
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Telephone | 865-692-1603
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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 | 5551
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License Number State | TN
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