Healthcare Provider Details

I. General information

NPI: 1669918256
Provider Name (Legal Business Name): PATRICK ANTHONY ALBANESE PHARMD, MD, MBA, BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 HWY 321 N UNIT 600
LENOIR CITY TN
37771
US

IV. Provider business mailing address

875 HWY 321 N UNIT 600
LENOIR CITY TN
37771
US

V. Phone/Fax

Practice location:
  • Phone: 321-591-5324
  • Fax: 321-362-7975
Mailing address:
  • Phone: 321-591-5324
  • Fax: 321-362-7975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number092390
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberPSI31092
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number092390
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPSI31092
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number092390
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: