Provider Demographics
NPI:1639382948
Name:MCFARLAND PHARMACY KNOXVILLE, INC
Entity Type:Organization
Organization Name:MCFARLAND PHARMACY KNOXVILLE, INC
Other - Org Name:MCFARLAND PHARMACY KNOXVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:B
Authorized Official - Last Name:DEBORD
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT, CPED, COF
Authorized Official - Phone:423-581-1118
Mailing Address - Street 1:167 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4628
Mailing Address - Country:US
Mailing Address - Phone:423-581-1118
Mailing Address - Fax:423-581-1104
Practice Address - Street 1:6908 HOSPITALITY CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1105
Practice Address - Country:US
Practice Address - Phone:865-531-2580
Practice Address - Fax:865-862-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42743336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519237Medicaid
TNBM9749675OtherDEA NUMBER
TNBM9749675OtherDEA NUMBER