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Contact Information

COLONIAL HEIGHTS PHARMACY, INC.
4221 FT. HENRY DRIVE
KINGSPORT, TN37663
 Phone: 423-239-9191
 Fax: 423-239-0382
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for COLONIAL HEIGHTS PHARMACY, INC.

NPI # 1619003399
LBN Legal business name COLONIAL HEIGHTS PHARMACY, INC.
Authorized official MARTHA DUNN - (PHARMACIST / PIC)
Entity Organization
Organization subpart 1 No
Enumeration date 02/26/2007
Last updated 10/13/2016 - About 10 years ago
Identifiers
TN License # 500
TN Medicaid 1452937
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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