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NPI Code Detail

MEDICARE: UNIVERSITY OF TENN ATHLETIC DEPT. PHARMACY

MEDICARE: UNIVERSITY OF TENN ATHLETIC DEPT. PHARMACY
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
1333600000XPharmacy318TN

General Provider Information

NPI Number : 1801297791
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF TENN ATHLETIC DEPT. PHARMACY
Provider Business Mailing Address
First Line : 1551 LAKE LOUDON BLVD
Second Line : A107
City : KNOXVILLE
State : TN
Zip : 37916-4009
Country : US
Telephone Number : 865-974-1231
Fax Number : 865-974-1259
Provider Business Practice Location Address
First Line : 1551 LAKE LOUDON BLVD
Second Line : A107
City : KNOXVILLE
State : TN
Zip : 37916-4009
Country : US
Telephone Number : 865-974-1231
Fax Number : 865-974-1259
Authorized Official
Title or Position : PHARMACIST IN CHARGE
Name : KERRY CHOLKA
Credential : PHARMD
Telephone Number : 865-974-1231
Provider Enumeration Date : 09/10/2014
Last Update Date : 09/10/2014

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Directions to “UNIVERSITY OF TENN ATHLETIC DEPT. PHARMACY ” Practice Location

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