Provider Demographics
NPI:1538342076
Name:ROSS ENTERPRISE INC
Entity type:Organization
Organization Name:ROSS ENTERPRISE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:III
Authorized Official - Credentials:DPH
Authorized Official - Phone:423-648-1040
Mailing Address - Street 1:2001 E 3RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-2610
Mailing Address - Country:US
Mailing Address - Phone:423-648-1040
Mailing Address - Fax:423-648-3131
Practice Address - Street 1:2001 E THIRD ST SUITE C
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2610
Practice Address - Country:US
Practice Address - Phone:423-648-1040
Practice Address - Fax:423-648-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN63113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy