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General NPI Number Information
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NPI Number | 1831286038
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Entity Type | Organization
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Legal Business Name | LARRY H PAFFORD
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Dates
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Enumeration Date | 10/07/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 5 S COURT ST
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City | ALAMO
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State | TN
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Zip | 38001-1708
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Country | US
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Telephone | 731-696-5577
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Fax | 731-696-4311
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Provider Business Mailing Address
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Address Line | 5 S COURT ST
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City | ALAMO
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State | TN
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Zip | 38001-1708
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Country | US
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Telephone | 731-696-5577
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Fax | 731-696-4311
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Authorized Official
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Title or Position | OWNER / PHARMACIST
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Name | LARRY H PAFFORD
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Credential |
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Telephone | 731-696-5577
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 104
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License Number State | TN
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