Healthcare Provider Details

I. General information

NPI: 1851317200
Provider Name (Legal Business Name): TED L. ROZELL JR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129-1237
US

IV. Provider business mailing address

1910 WINDSOR ST
MURFREESBORO TN
37130-1719
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-1360
  • Fax:
Mailing address:
  • Phone: 615-890-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4192
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: