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General NPI Number Information
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NPI Number | 1932261658
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Entity Type | Organization
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Legal Business Name | DANNY B DEDMON
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Dates
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Enumeration Date | 12/16/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 101 S MILL AVE
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City | DYERSBURG
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State | TN
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Zip | 38024-4636
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Country | US
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Telephone | 731-285-7284
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Fax | 731-285-8959
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Provider Business Mailing Address
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Address Line | 101 S MILL AVE P O DRAWER C
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City | DYERSBURG
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State | TN
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Zip | 38024-4636
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Country | US
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Telephone | 731-285-7284
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Fax | 731-285-8959
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Authorized Official
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Title or Position | OWNER-PHARMACIST
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Name | DR. DANNY B DEDMON
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Credential | D.PH
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Telephone | 731-285-7284
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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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