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NPI Code Detail

MEDICARE: PRESCOTT FISHER III RPH

MEDICARE: PRESCOTT FISHER III RPH
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
1183500000XPharmacist8419TN

General Provider Information

NPI Number : 1467790899
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRESCOTT FISHER III RPH
Provider Business Mailing Address
First Line : 15544 OLD HICKORY BLVD
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-7329
Country : US
Telephone Number : 615-331-4966
Fax Number :
Provider Business Practice Location Address
First Line : 15544 OLD HICKORY BLVD
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-7329
Country : US
Telephone Number : 615-331-4966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2013
Last Update Date : 01/18/2013

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