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General NPI Number Information
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NPI Number | 1912049503
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Entity Type | Organization
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Legal Business Name | MUGFORD PHARMACY INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3909 MARTIN MILL PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37920-2456
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Country | US
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Telephone | 865-577-5533
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Fax | 865-577-9959
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Provider Business Mailing Address
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Address Line | 3909 MARTIN MILL PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37920-2456
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Country | US
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Telephone | 865-577-5533
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Fax | 865-577-9959
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Authorized Official
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Title or Position | SECTARY
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Name | MR. MICHAEL A DUBAN
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Credential |
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Telephone | 865-577-5533
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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 | 568
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License Number State | TN
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