Provider Demographics
NPI:1144926338
Name:TOWN CREEK PHARMACY, LLC
Entity type:Organization
Organization Name:TOWN CREEK PHARMACY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:865-317-1045
Mailing Address - Street 1:950 HIGHWAY 321 N STE D
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-6424
Mailing Address - Country:US
Mailing Address - Phone:865-317-1045
Mailing Address - Fax:865-317-1141
Practice Address - Street 1:950 HIGHWAY 321 N STE D
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-6424
Practice Address - Country:US
Practice Address - Phone:865-317-1045
Practice Address - Fax:865-317-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy