Tara Mistell Douglas

Individual provider Active NPI Pharmacy Technician · Oneida, TN

NPI 1184153264 · NPPES record last updated Jun 12, 2017

Key facts

NPI
1184153264
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
19006 (TN)
Practice address
279 Underpass Dr
Oneida, TN 37841-5885
Phone
(423) 569-7800
NPI assigned
Jun 12, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Marks Family Pharmacy LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 19006 TN Yes

Addresses

Primary practice location

279 Underpass Dr
Oneida, TN 37841-5885

Mailing address

749 Bart Grant Hollow Rd
Winfield, TN 37892-3664

Other identifiers

IdentifierTypeStateIssuer
19006OtherTNSTATE OF TENNESSE BOARD OF PHARMACY

Other providers in Oneida, TN

All providers in Oneida, TN · Pharmacy Technician in Tennessee

Sources for this page

Verify at the official NPI Registry.