Provider Demographics
NPI:1609901628
Name:CLINCHFIELD DRUG CO. INC
Entity type:Organization
Organization Name:CLINCHFIELD DRUG CO. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:423-743-4881
Mailing Address - Street 1:101 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1237
Mailing Address - Country:US
Mailing Address - Phone:423-743-4881
Mailing Address - Fax:423-743-0947
Practice Address - Street 1:101 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1237
Practice Address - Country:US
Practice Address - Phone:423-743-4881
Practice Address - Fax:423-743-0947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN359OtherTENNESSEE STATE PHARMACY
TN4406256OtherNCPDP- NABP NUMBER
TNAC0407747OtherDEA NUMBER