Provider Demographics
NPI:1275548877
Name:UNITED APOTHECARY INC
Entity Type:Organization
Organization Name:UNITED APOTHECARY INC
Other - Org Name:RIDDLE EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC PHCY MGR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-456-4564
Mailing Address - Street 1:PO BOX 5688
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831-5688
Mailing Address - Country:US
Mailing Address - Phone:931-456-4564
Mailing Address - Fax:931-456-4584
Practice Address - Street 1:1645 S MAIN ST
Practice Address - Street 2:STE 102
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-2908
Practice Address - Country:US
Practice Address - Phone:931-456-4564
Practice Address - Fax:931-456-4584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN39853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2094096OtherPK
1119420003Medicare NSC