MEDICARE: DR. JENNIFER K. PHILLIPS 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
1	183500000X	Pharmacist	11809	TN

General Provider Information

NPI Number	:	1609952316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER K. PHILLIPS PHARMD

Provider Business Mailing Address
First Line	:	320 W 9TH ST
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-3103
Country	:	US
Telephone Number	:	931-381-7146
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 NASHVILLE HWY
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-2428
Country	:	US
Telephone Number	:	931-388-4884
Fax Number	:	931-388-9354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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