NPI: 1902948003 · OOLTEWAH, TN 37363 · Pharmacy · NPI assigned 02/13/2007
| Authorized Official | BOHANNON, GREG (MANAGER) |
| NPI Enumeration Date | 02/13/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 12 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90657 | 12 | 12 | $0.00 |