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General NPI Number Information
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NPI Number | 1609901628
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Entity Type | Organization
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Legal Business Name | CLINCHFIELD DRUG CO. INC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 101 S MAIN AVE
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City | ERWIN
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State | TN
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Zip | 37650-1237
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Country | US
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Telephone | 423-743-4881
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Fax | 423-743-0947
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Provider Business Mailing Address
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Address Line | 101 S MAIN AVE
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City | ERWIN
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State | TN
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Zip | 37650-1237
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Country | US
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Telephone | 423-743-4881
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Fax | 423-743-0947
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Authorized Official
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Title or Position | PIC
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Name | MR. JOSEPH C SNYDER
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Credential | DPH
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Telephone | 423-743-4881
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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 | 359
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License Number State | TN
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