Healthcare Provider Details

I. General information

NPI: 1821606807
Provider Name (Legal Business Name): SOPHIA DUNAVANT LEVENGOOD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N PAULINE ST
MEMPHIS TN
38104-1005
US

IV. Provider business mailing address

4917 FAIRFIELD CIR S
MEMPHIS TN
38117-4209
US

V. Phone/Fax

Practice location:
  • Phone: 901-523-8990
  • Fax:
Mailing address:
  • Phone: 901-463-0208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number43455
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: