City Drug Institutional Care

Organization Active NPI Long Term Care Pharmacy · Henderson, TN

NPI 1649475252 · NPPES record last updated Sep 13, 2007

Key facts

NPI
1649475252
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 3336L0003X
License
TN4396 (TN)
Legal business name
CITY DRUG INSTITUTIONAL CARE
Practice address
118 E Main St
Ste C
Henderson, TN 38340-2335
Phone
(731) 989-2166
Fax
(731) 989-9685
NPI assigned
Jun 15, 2007
Organization subpart
No

Authorized official

Name
Deryl Stewart, PHRMD
Title
President
Phone
(731) 989-2166

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
City Drug Institutional Care (3 organizations share this tax ID)

Locations

118 E Main St
Ste C
Henderson, TN 38340
Phone (731) 989-2166

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X TN4396 TN Yes

Addresses

Primary practice location

118 E Main St
Ste C
Henderson, TN 38340-2335

Mailing address

PO Box 224
Henderson, TN 38340-0224

Other identifiers

IdentifierTypeStateIssuer
4440513OtherOTHER ID NUMBER

Other providers in Henderson, TN

All providers in Henderson, TN · Long Term Care Pharmacy in Tennessee

Sources for this page

Verify at the official NPI Registry.