Provider Demographics
NPI:1598776163
Name:STANLEY & WATTS INC
Entity Type:Organization
Organization Name:STANLEY & WATTS INC
Other - Org Name:ARNOLD DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:731-836-7211
Mailing Address - Street 1:400A S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HALLS
Mailing Address - State:TN
Mailing Address - Zip Code:38040-1555
Mailing Address - Country:US
Mailing Address - Phone:731-836-7211
Mailing Address - Fax:731-836-0344
Practice Address - Street 1:400A S CHURCH ST
Practice Address - Street 2:
Practice Address - City:HALLS
Practice Address - State:TN
Practice Address - Zip Code:38040-1555
Practice Address - Country:US
Practice Address - Phone:731-836-7211
Practice Address - Fax:731-836-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN22783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ033943Medicaid
2095487OtherPK
TN3518809Medicaid