Provider Demographics
NPI:1730100793
Name:LEES TOTAL HEALTH PHARMACY INC
Entity Type:Organization
Organization Name:LEES TOTAL HEALTH PHARMACY INC
Other - Org Name:LEES TOTAL HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:865-428-7252
Mailing Address - Street 1:1024 MIDDLE CREEK RD
Mailing Address - Street 2:STE 1
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6921
Mailing Address - Country:US
Mailing Address - Phone:865-429-2051
Mailing Address - Fax:865-429-2258
Practice Address - Street 1:1024 MIDDLE CREEK RD
Practice Address - Street 2:STE 1
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-6921
Practice Address - Country:US
Practice Address - Phone:865-429-2051
Practice Address - Fax:865-429-2258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X
TN42453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2094884OtherPK