| Surgoinsville Pharmacy | |
|
114 Bellamy Avenue Surgoinsville TN 37873 | |
| (423) 345-0333 | |
| (423) 345-0336 |
| Full Name | Surgoinsville Pharmacy |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 114 Bellamy Avenue, Surgoinsville, Tennessee |
| Authorized Official Name and Position | Beth a Bryan (OWNER/PHARMACIST) |
| Authorized Official Contact | 4233450333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Surgoinsville Pharmacy P.o. Box 105 Surgoinsville TN 37873 Ph: (423) 345-0333 | Surgoinsville Pharmacy 114 Bellamy Avenue Surgoinsville TN 37873 Ph: (423) 345-0333 |
| NPI Number | 1871724708 |
|---|---|
| Provider Enumeration Date | 07/27/2009 |
| Last Update Date | 03/24/2025 |
| Certification Date | 03/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871724708 | NPI | - | NPPES |
| Q045913 | Medicaid | TN | |
| 4442694 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QH0100X | Clinic/center - Health Service | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
The Clinic Surgoinsville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Bellamy Ave Ste B, Surgoinsville, TN 37873 Phone: 423-345-6271 |