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General NPI Number Information
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NPI Number | 1679281505
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Entity Type | Organization
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Legal Business Name | WILSONS SAV-MOR DRUGS LLC
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 265 E MAIN ST
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City | NEWPORT
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State | TN
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Zip | 37821-3126
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Country | US
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Telephone | 423-623-3456
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Fax | 423-623-3049
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Provider Business Mailing Address
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Address Line | 265 E MAIN ST
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City | NEWPORT
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State | TN
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Zip | 37821-3126
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Country | US
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Telephone | 423-623-3456
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Fax | 423-623-3049
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ROBERT WAYNE BULLINGTON
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Credential | PHARMD
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Telephone | 901-355-5556
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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