Provider Demographics
NPI:1093271561
Name:BUNCH MEDICAL LLC
Entity Type:Organization
Organization Name:BUNCH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:VICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:423-289-1111
Mailing Address - Street 1:1467 W MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2828
Mailing Address - Country:US
Mailing Address - Phone:423-289-1111
Mailing Address - Fax:423-289-1121
Practice Address - Street 1:1467 W MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2828
Practice Address - Country:US
Practice Address - Phone:423-289-1111
Practice Address - Fax:423-289-1121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M.D. PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy