Provider Demographics
NPI:1912348830
Name:T.G.B.T.G. ENTERPRISE INC.
Entity Type:Organization
Organization Name:T.G.B.T.G. ENTERPRISE INC.
Other - Org Name:FAMILY DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:II
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:423-923-4695
Mailing Address - Street 1:702 W HIGHWAY 25 70
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-9020
Mailing Address - Country:US
Mailing Address - Phone:423-625-6178
Mailing Address - Fax:423-625-6180
Practice Address - Street 1:702 W HIGHWAY 25 70
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-9020
Practice Address - Country:US
Practice Address - Phone:423-625-6178
Practice Address - Fax:423-625-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty