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NPI Code Detail

MEDICARE: MEDICAL CENTER PHARMACY INC

MEDICARE: MEDICAL CENTER PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies0000000700TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033277447
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL CENTER PHARMACY INC
Provider Business Mailing Address
First Line : PO BOX 3240
Second Line :
City : CLEVELAND
State : TN
Zip : 37320-3240
Country : US
Telephone Number : 423-476-5547
Fax Number : 423-472-0125
Provider Business Practice Location Address
First Line : 2401 N OCOEE ST
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3853
Country : US
Telephone Number : 423-476-5547
Fax Number : 423-472-0125
Authorized Official
Title or Position : OWNER
Name : MR. JOE MOORE
Credential :
Telephone Number : 423-476-5547
Provider Enumeration Date : 12/05/2006
Last Update Date : 06/29/2017

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Directions to “MEDICAL CENTER PHARMACY INC ” Practice Location

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