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MARK CORUM

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1669865440

Individual Registrant:
 MARK  CORUM 
Gender: M
Sole Proprietor

Location and contact information for practice:
1212 STATE ST  WHITE PINE, TN 37890-3467 US
Tel: 865-674-7517  Fax: --

Contact information for business:
868 SELLERS RD  JEFFERSON CITY, TN 37760-4203 US
Tel: 865-591-6942  Fax: --

Registration Information:
NPI: 1669865440
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
TN9174

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS TN - Page 1



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