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General NPI Number Information
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NPI Number | 1710760996
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Entity Type | Organization
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Legal Business Name | COLEMAN'S PHARMACY
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 319 E EATON ST
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City | TRENTON
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State | TN
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Zip | 38382-1806
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Country | US
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Telephone | 731-200-9050
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Fax | 731-200-9119
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Provider Business Mailing Address
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Address Line | 319 E EATON ST
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City | TRENTON
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State | TN
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Zip | 38382-1806
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Country | US
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Telephone | 731-200-9050
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Fax | 731-200-9119
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Authorized Official
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Title or Position | OWNER
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Name | KENT DWAYNE COLEMAN
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Credential | RPH
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Telephone | 700-200-9050
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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 |
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License Number State |
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