Provider Demographics
NPI:1720149909
Name:UNITED APOTHECARY INC
Entity Type:Organization
Organization Name:UNITED APOTHECARY INC
Other - Org Name:RIDDLE EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:865-483-4589
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:865-425-1260
Mailing Address - Fax:865-425-1262
Practice Address - Street 1:392 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TN
Practice Address - Zip Code:37322-7759
Practice Address - Country:US
Practice Address - Phone:423-334-8099
Practice Address - Fax:423-334-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN40883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2094610OtherPK