Healthcare Provider Details

I. General information

NPI: 1891778841
Provider Name (Legal Business Name): CARDINAL HEALTH 128 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
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: 866-716-5486
  • Fax: 866-750-0823
Mailing address:
  • Phone: 866-716-5486
  • Fax: 866-750-0823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number3886
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. NAVEEN MANSUKHANI
Title or Position: VICE PRESIDENT, MANAGED SERVICES
Credential:
Phone: 281-749-4764