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NPI Code Detail

MEDICARE: ASHLEY BOLSTER

MEDICARE: ASHLEY BOLSTER
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
1183500000XPharmacist42620TN

General Provider Information

NPI Number : 1821609876
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY BOLSTER
Provider Business Mailing Address
First Line : 9200 MIDDLEBROOK PIKE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-4701
Country : US
Telephone Number : 865-531-0033
Fax Number :
Provider Business Practice Location Address
First Line : 7810 OAK RIDGE HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-2313
Country : US
Telephone Number : 865-690-5357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2020
Last Update Date : 05/12/2022

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Directions to “ ASHLEY BOLSTER ” Practice Location

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