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General NPI Number Information
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NPI Number | 1629371174
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Entity Type | Organization
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Legal Business Name | PHARMDAX LLC
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 101 SHERLAKE LN SUITE 204
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City | KNOXVILLE
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State | TN
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Zip | 37922-3473
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Country | US
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Telephone | 865-357-4120
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Fax | 865-357-5142
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Provider Business Mailing Address
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Address Line | PO BOX 30086
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City | KNOXVILLE
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State | TN
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Zip | 37930-0086
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Country | US
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Telephone | 865-357-4120
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Fax | 865-357-5142
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. JAMES ANDREW AXMACHER
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Credential | PHARM. D.
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Telephone | 865-805-3864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 4807
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License Number State | TN
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