STATE OF TENNESSEE
1216 Trotwood Ave
Columbia, TN 38401
931-490-8366
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | TN | 0000002135 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP | 4440640 | TN | OTHER |