Provider Demographics
NPI:1669536298
Name:UNITED APOTHECARY INC
Entity type:Organization
Organization Name:UNITED APOTHECARY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-435-3333
Mailing Address - Street 1:PO BOX 5688
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831-5688
Mailing Address - Country:US
Mailing Address - Phone:865-435-3333
Mailing Address - Fax:865-435-2194
Practice Address - Street 1:616 E TRI COUNTY BLVD
Practice Address - Street 2:
Practice Address - City:OLIVER SPRINGS
Practice Address - State:TN
Practice Address - Zip Code:37840-5413
Practice Address - Country:US
Practice Address - Phone:865-435-3333
Practice Address - Fax:865-435-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1119420001Medicare ID - Type Unspecified