Healthcare Provider Details

I. General information

NPI: 1740155936
Provider Name (Legal Business Name): ABIGAIL MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST
CHATTANOOGA TN
37403-2173
US

IV. Provider business mailing address

1088 BEXLEY SQ APT 209
CHATTANOOGA TN
37410
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number48432
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: