Healthcare Provider Details

I. General information

NPI: 1720097603
Provider Name (Legal Business Name): BRENT EDWARD SALVIG RPH, PHARMD, BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129-1237
US

IV. Provider business mailing address

3400 LEBANON RD
MURFREESBORO TN
37129-1237
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-7530
  • Fax:
Mailing address:
  • Phone: 615-225-6357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number051.040551
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: