Healthcare Provider Details

I. General information

NPI: 1730293721
Provider Name (Legal Business Name): FAIRVIEW PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2243 FAIRVIEW BLVD
FAIRVIEW TN
37062-9070
US

IV. Provider business mailing address

2243 FAIRVIEW BLVD
FAIRVIEW TN
37062-9070
US

V. Phone/Fax

Practice location:
  • Phone: 615-799-0600
  • Fax: 615-799-9849
Mailing address:
  • Phone: 615-799-0600
  • Fax: 615-799-9849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0000000088
License Number StateTN

VIII. Authorized Official

Name: JAMES ANDERSON
Title or Position: OWNER
Credential:
Phone: 615-799-0600