Provider Demographics
NPI:1275231052
Name:MARCUM'S PHARMACY, INC
Entity Type:Organization
Organization Name:MARCUM'S PHARMACY, INC
Other - Org Name:MARCUM'S SAFEPAK PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLTON
Authorized Official - Middle Name:N
Authorized Official - Last Name:MARCUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:423-246-6166
Mailing Address - Street 1:902 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3815
Mailing Address - Country:US
Mailing Address - Phone:423-246-6166
Mailing Address - Fax:423-246-9259
Practice Address - Street 1:902 BROAD ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3815
Practice Address - Country:US
Practice Address - Phone:423-246-6166
Practice Address - Fax:423-246-9259
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARCUM'S PHARMACY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy