MEDICARE: RUSSELL ESSARY PHARMD

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
1	183500000X	Pharmacist	23943	TN

General Provider Information

NPI Number	:	1275660318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL ESSARY PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 1438
Second Line	:
City	:	NEW TAZEWELL
State	:	TN
Zip	:	37824-1438
Country	:	US
Telephone Number	:	423-626-7337
Fax Number	:	423-626-0189

Provider Business Practice Location Address
First Line	:	420 N BROAD ST
Second Line	:
City	:	NEW TAZEWELL
State	:	TN
Zip	:	37825-6606
Country	:	US
Telephone Number	:	423-626-7337
Fax Number	:	423-626-0189

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	04/05/2024

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Directions to “ RUSSELL ESSARY PHARMD” Practice Location

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