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General NPI Number Information
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NPI Number | 1881676260
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Entity Type | Organization
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Legal Business Name | CAMPBELL COUNTY HMA LLC
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 923 E CENTRAL AVE
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City | LA FOLLETTE
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State | TN
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Zip | 37766-2768
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Country | US
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Telephone | 423-907-1489
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Fax |
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Provider Business Mailing Address
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Address Line | 923 E CENTRAL AVE
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City | LA FOLLETTE
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State | TN
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Zip | 37766-2768
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Country | US
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Telephone | 423-907-1489
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | LEE SEARGEANT
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Credential |
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Telephone | 423-907-1489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 1360
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License Number State | TN
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