Provider Demographics
NPI:1083892087
Name:LEES TOTAL HEALTH PHARMACY INC
Entity Type:Organization
Organization Name:LEES TOTAL HEALTH PHARMACY INC
Other - Org Name:LEES TOTAL HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:865-368-0383
Mailing Address - Street 1:2453 BOYDS CREEK HWY
Mailing Address - Street 2:STE 201
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37876-0676
Mailing Address - Country:US
Mailing Address - Phone:865-428-7439
Mailing Address - Fax:865-453-4515
Practice Address - Street 1:2453 BOYDS CREEK HWY
Practice Address - Street 2:STE 201
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37876-0676
Practice Address - Country:US
Practice Address - Phone:865-428-7439
Practice Address - Fax:865-453-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4440993OtherNCPDP PROVIDER IDENTIFICATION NUMBER