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NPI Code Detail

MEDICARE: DR. JONATHAN DOUGLAS ALLRED PHARM. D

MEDICARE: DR. JONATHAN DOUGLAS ALLRED PHARM. D
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
1183500000XPharmacist0000033715TN

General Provider Information

NPI Number : 1447672837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN DOUGLAS ALLRED PHARM. D
Provider Business Mailing Address
First Line : PO BOX 844
Second Line :
City : JAMESTOWN
State : TN
Zip : 38556-0844
Country : US
Telephone Number : 931-397-5504
Fax Number : 931-879-9365
Provider Business Practice Location Address
First Line : 346 W CENTRAL AVE
Second Line :
City : JAMESTOWN
State : TN
Zip : 38556-3407
Country : US
Telephone Number : 931-879-8133
Fax Number : 931-879-9365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2014
Last Update Date : 01/20/2014

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