Healthcare Provider Details

I. General information

NPI: 1770879736
Provider Name (Legal Business Name): LELA CAMILLE THORNTON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 JEFFERSON AVE
MEMPHIS TN
38103-2807
US

IV. Provider business mailing address

8969 PLANTERS WOOD CV
BARTLETT TN
38133-4243
US

V. Phone/Fax

Practice location:
  • Phone: 901-545-6856
  • Fax: 901-545-7177
Mailing address:
  • Phone: 901-233-3762
  • Fax: 901-545-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number10116
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: