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General NPI Number Information
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NPI Number | 1689611493
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Entity Type | Organization
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Legal Business Name | CLEVELAND WORX LLC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1690 25TH ST NW SUITE A
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City | CLEVELAND
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State | TN
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Zip | 37311
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Country | US
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Telephone | 423-559-3000
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Fax | 423-559-3007
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Provider Business Mailing Address
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Address Line | 1690 25TH ST NW SUITE A
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City | CLEVELAND
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State | TN
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Zip | 37311
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Country | US
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Telephone | 423-559-3000
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Fax | 423-559-3007
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | CHAD SMITH
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Credential |
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Telephone | 423-559-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 24
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 24
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License Number State | TN
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