Healthcare Provider Details

I. General information

NPI: 1538726211
Provider Name (Legal Business Name): AIRVILLE PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 AIRPORT RD STE A
GALLATIN TN
37066-3740
US

IV. Provider business mailing address

1010 MERRICK RD
HENDERSONVILLE TN
37075-1721
US

V. Phone/Fax

Practice location:
  • Phone: 615-675-5507
  • Fax: 615-206-8255
Mailing address:
  • Phone: 615-587-8203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. UGOCHUKWU BEN-NWAUZOR
Title or Position: CEO/PRESIDENT
Credential: BPHARM, MSC., PHD
Phone: 615-587-8203