Provider Demographics
NPI:1174178982
Name:ROAN DRUG COMPANY LLC
Entity Type:Organization
Organization Name:ROAN DRUG COMPANY LLC
Other - Org Name:THE MEDICINE SHOPPE 2141
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:EPLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-928-2000
Mailing Address - Street 1:1238 E JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-4771
Mailing Address - Country:US
Mailing Address - Phone:423-928-2000
Mailing Address - Fax:423-928-2001
Practice Address - Street 1:1301 N ROAN ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3941
Practice Address - Country:US
Practice Address - Phone:423-928-2000
Practice Address - Fax:423-928-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy