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NPI Code Detail

MEDICARE: CAROL WALLACE MCKEE RPH

MEDICARE:   CAROL WALLACE MCKEE  RPH
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
1183500000XPharmacist2005TN

General Provider Information

NPI Number : 1801135462
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL WALLACE MCKEE RPH
Provider Business Mailing Address
First Line : 122 FLEETWOOD DR
Second Line :
City : LOOKOUT MTN
State : TN
Zip : 37350-1406
Country : US
Telephone Number : 423-822-7979
Fax Number : 423-822-7979
Provider Business Practice Location Address
First Line : 122 FLEETWOOD DR
Second Line :
City : LOOKOUT MTN
State : TN
Zip : 37350-1406
Country : US
Telephone Number : 423-822-7979
Fax Number : 423-822-7979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2013
Last Update Date : 02/01/2013

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Directions to “ CAROL WALLACE MCKEE RPH” Practice Location

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