William David Roe Jr.

Individual provider Active NPI Pharmacist · Humboldt, TN

NPI 1942340922 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1942340922
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
7732 (TN)
Practice address
1511 E Main St
Humboldt, TN 38343-2901
Phone
(731) 784-2724
Fax
(731) 784-5801
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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
City Drug Co of Humboldt Past Accepting new patients
City Drug Company Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7732 TN Yes

Addresses

Primary practice location

1511 E Main St
Humboldt, TN 38343-2901

Mailing address

1511 E Main St
Humboldt, TN 38343-2901
Phone (731) 784-2724

Other providers in Humboldt, TN

All providers in Humboldt, TN · Pharmacist in Tennessee

Sources for this page

Verify at the official NPI Registry.