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NPI Code Detail

MEDICARE: SAMANTHA DALE WILLIAMS HENSLEY PHARMD

MEDICARE: SAMANTHA DALE WILLIAMS HENSLEY 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
1183500000XPharmacist41604TN

General Provider Information

NPI Number : 1831787357
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA DALE WILLIAMS HENSLEY PHARMD
Provider Business Mailing Address
First Line : PO BOX 1279
Second Line :
City : WARTBURG
State : TN
Zip : 37887-1279
Country : US
Telephone Number : 423-346-7800
Fax Number :
Provider Business Practice Location Address
First Line : 1236 KNOXVILLE HWY
Second Line :
City : WARTBURG
State : TN
Zip : 37887-4200
Country : US
Telephone Number : 423-346-7800
Fax Number : 423-346-7875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2021
Last Update Date : 01/10/2021

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