Healthcare Provider Details

I. General information

NPI: 1073996419
Provider Name (Legal Business Name): YOUSEF BEHBAHANI PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 07/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 WILMA RUDOLPH BLVD
CLARKSVILLE TN
37040-5897
US

IV. Provider business mailing address

2780 WILMA RUDOLPH BLVD
CLARKSVILLE TN
37040-5897
US

V. Phone/Fax

Practice location:
  • Phone: 931-552-0908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number39510
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: