Healthcare Provider Details

I. General information

NPI: 1538407127
Provider Name (Legal Business Name): CASEY PAIGE LEWIS PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PHYSICIANS WAY
LEBANON TN
37090-8102
US

IV. Provider business mailing address

112 ALBRIGHT RD
OAK RIDGE TN
37830-7838
US

V. Phone/Fax

Practice location:
  • Phone: 865-207-0672
  • Fax:
Mailing address:
  • Phone: 865-207-0672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number0000034325
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: