Healthcare Provider Details

I. General information

NPI: 1073652103
Provider Name (Legal Business Name): CHRISTOPHER BRENT TAYLOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 S MILL ST
LINDEN TN
37096-6457
US

IV. Provider business mailing address

119 S MILL ST
LINDEN TN
37096-6457
US

V. Phone/Fax

Practice location:
  • Phone: 931-589-2146
  • Fax: 931-589-2890
Mailing address:
  • Phone: 931-589-2146
  • Fax: 931-589-2890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number13001
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13001
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: