C MICHAEL JONES MDPC
7710 Wolf River Cir
Germantown, TN 38138
901-685-5969
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | TN | 0000003590 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 4434798 | OTHER | |
4434798A | TN | MEDICAID |