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General NPI Number Information
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NPI Number | 1851364483
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Entity Type | Organization
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Legal Business Name | CATES STREET PHARMACY LLC
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 104 CATES ST
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City | DUNLAP
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State | TN
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Zip | 37327-6093
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Country | US
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Telephone | 423-949-5722
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Fax | 423-949-6176
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Provider Business Mailing Address
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Address Line | PO BOX 1685
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City | DUNLAP
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State | TN
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Zip | 37327-1685
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Country | US
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Telephone | 423-949-5722
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Fax | 423-949-6176
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Authorized Official
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Title or Position | MANAGER
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Name | JACOB STANDEFER
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Credential |
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Telephone | 423-877-3568
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 00003967
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License Number State | TN
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