Community Pharmacy

LBN: Formulab Llc
Community Pharmacy is an health care organization with primary practice located at 5821 Walden Dr , Knoxville TN 37919-6334. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Formulab Llc can be contacted via phone (865) 588-0689, or through Wyatt, Scotty via phone (865) 588-0689.

Contact Information

Primary practice address
5821 Walden Dr Knoxville TN 37919-6334
Phone: (865) 588-0689
Fax: (865) 588-0680
Website:
Map and Directions
Authorized official contact:
Name: Wyatt, Scotty
Phone: (865) 588-0689

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 128 Tennessee

Profile Details

NPI number 1174834758
LBN Legal business name Formulab Llc
DBA Doing business as Community Pharmacy
Authorized official Wyatt, Scotty
Entity Organization
Organization subpart 1 No
Enumeration date Jun 29th, 2010
Last updated May 16th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174834758 NPPES
Other 4443420 NCPDP PROVIDER IDENTIFICATION NUMBER

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