Healthcare Provider Details

I. General information

NPI: 1205142940
Provider Name (Legal Business Name): KEREN E RODRIGUEZ PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 MASON RD
LA VERGNE TN
37086-3212
US

IV. Provider business mailing address

239 MASON RD
LA VERGNE TN
37086-3212
US

V. Phone/Fax

Practice location:
  • Phone: 866-835-6330
  • Fax: 614-652-0888
Mailing address:
  • Phone: 866-835-6330
  • Fax: 614-652-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35464
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: