Provider Demographics
NPI:1518656586
Name:MAC'S PHARMACY AT BROWN'S CREEK, LLC
Entity Type:Organization
Organization Name:MAC'S PHARMACY AT BROWN'S CREEK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WILHOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-945-3333
Mailing Address - Street 1:1612 E LAMAR ALEXANDER PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-6206
Mailing Address - Country:US
Mailing Address - Phone:865-982-7162
Mailing Address - Fax:
Practice Address - Street 1:1612 E LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-6206
Practice Address - Country:US
Practice Address - Phone:865-982-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy