Provider Demographics
NPI:1356729719
Name:DEERBORN RX
Entity type:Organization
Organization Name:DEERBORN RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAFFURS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-671-7788
Mailing Address - Street 1:10360 DEERBORN LN STE 2
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2577
Mailing Address - Country:US
Mailing Address - Phone:865-671-7792
Mailing Address - Fax:865-671-0064
Practice Address - Street 1:10360 DEERBORN LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-2577
Practice Address - Country:US
Practice Address - Phone:865-671-7792
Practice Address - Fax:865-671-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Single Specialty