Provider Demographics
NPI:1639283526
Name:TOWN & COUNTRY DRUGS
Entity Type:Organization
Organization Name:TOWN & COUNTRY DRUGS
Other - Org Name:TOWN & COUNTRY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-623-1500
Mailing Address - Street 1:771 COSBY HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3426
Mailing Address - Country:US
Mailing Address - Phone:423-623-1500
Mailing Address - Fax:423-625-1196
Practice Address - Street 1:771 COSBY HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3426
Practice Address - Country:US
Practice Address - Phone:423-623-1500
Practice Address - Fax:423-625-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN00000012983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN944-1184Medicaid
2124849OtherPK