Provider Demographics
NPI:1831280742
Name:BOATWRIGHT DRUG CO., INC
Entity Type:Organization
Organization Name:BOATWRIGHT DRUG CO., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:901-872-2214
Mailing Address - Street 1:7899 C ST
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-2137
Mailing Address - Country:US
Mailing Address - Phone:901-872-2214
Mailing Address - Fax:
Practice Address - Street 1:7899 C ST
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-2137
Practice Address - Country:US
Practice Address - Phone:901-872-2214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4401737OtherNCPDP / NABP
TN4401737OtherNCPDP / NABP