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General NPI Number Information
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NPI Number | 1730915356
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Entity Type | Individual
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Provider Name | CAITLYN GRACE RAINES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 116 OCOEE ST
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City | COPPERHILL
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State | TN
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Zip | 37317-4071
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Country | US
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Telephone | 423-496-5241
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Fax |
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Provider Business Mailing Address
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Address Line | 103 QUALLS DR
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City | BENTON
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State | TN
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Zip | 37307-5852
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Country | US
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Telephone | 423-813-9656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 48044
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License Number State | TN
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