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NPI Code Detail

MEDICARE: TRACEY SHOTWELL PHARMD

MEDICARE: TRACEY SHOTWELL PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist11264TN

General Provider Information

NPI Number : 1033472097
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY SHOTWELL PHARMD
Provider Business Mailing Address
First Line : 913 ABBEY GROVE LN
Second Line :
City : CORDOVA
State : TN
Zip : 38018-8216
Country : US
Telephone Number : 901-737-2458
Fax Number :
Provider Business Practice Location Address
First Line : 2471 JACKSON AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38108-3318
Country : US
Telephone Number : 901-454-1615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2012
Last Update Date : 06/24/2012

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Directions to “ TRACEY SHOTWELL PHARMD” Practice Location

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