Provider Demographics
NPI:1356850010
Name:UNITED APOTHECARY, LLC
Entity Type:Organization
Organization Name:UNITED APOTHECARY, LLC
Other - Org Name:RENNER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-441-8261
Mailing Address - Street 1:9724 KINGSTON PIKE STE 1402
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6928
Mailing Address - Country:US
Mailing Address - Phone:865-696-4404
Mailing Address - Fax:888-525-0289
Practice Address - Street 1:3005 E RENNER RD STE 120
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3570
Practice Address - Country:US
Practice Address - Phone:888-525-2010
Practice Address - Fax:888-525-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy