Healthcare Provider Details

I. General information

NPI: 1376753871
Provider Name (Legal Business Name): HEATHER LOVETT GRIFFIN HEATHER GRIFFIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER LOVETT GRIFFIN HEATHER GRIFFIN

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 HORIZON LAKE DR SUITE 101
MEMPHIS TN
38133-8119
US

IV. Provider business mailing address

8278 THORNE DRIVE
BARTLETT TN
38002
US

V. Phone/Fax

Practice location:
  • Phone: 877-882-7820
  • Fax: 901-384-8002
Mailing address:
  • Phone: 901-752-3949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13053
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: