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JELLICO DRUG STORE INC

Medical Equipment Supplier Yellow Pages

Jellico, Tennessee

Provider NPI: 1093753196

Organization Information:
Organization Name:  JELLICO DRUG STORE INC


Practice Location:
229 S MAIN ST  JELLICO, TN 37762 US
Tel: 423-784-6226  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332BP3500XSuppliers
Durable Medical Equipment & Medical Supplies
Parenteral & Enteral Nutrition
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
Y3336C0003XSuppliers
Pharmacy
TN472

Other Provider Identifiers:

IssuerNumberStateType
4407210TN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




JOBS TN - Page 1



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