Healthcare Provider Details

I. General information

NPI: 1164791968
Provider Name (Legal Business Name): STEVE T PHARR DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 MURFREESBORO RD
LA VERGNE TN
37086-2705
US

IV. Provider business mailing address

7233 WILD APPLE CT
ANTIOCH TN
37013-4898
US

V. Phone/Fax

Practice location:
  • Phone: 615-213-1930
  • Fax:
Mailing address:
  • Phone: 615-473-9437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4376
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: